Provider Demographics
NPI:1780783407
Name:YUNKER, JENNIFER LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:YUNKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4711 TRANSIT RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4888
Mailing Address - Country:US
Mailing Address - Phone:716-668-5331
Mailing Address - Fax:716-668-5370
Practice Address - Street 1:4711 TRANSIT RD
Practice Address - Street 2:SUITE 1
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4888
Practice Address - Country:US
Practice Address - Phone:716-668-5331
Practice Address - Fax:716-668-5370
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228619208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026412401OtherUNIVERA
NY040426003125OtherFIDELIS
1008313170001OtherPA MEDICAID
NY000527325001OtherBC/BS
NY02409025Medicaid
NY071213000077OtherFIDELIS
NY1211654OtherIHA
NY080407000138OtherFIDELIS
NY00026412401OtherUNIVERA
NY02409025Medicaid