Basic Information
Provider Information
NPI: 1508180472
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUNKER
FirstName: DANIEL
MiddleName: ROBERT
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3800 RESERVOIR RD NW STE 3004
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200072113
CountryCode: US
TelephoneNumber: 2024446200
FaxNumber: 8776251471
Practice Location
Address1: ONE GUSTAVE L. LEVY PLACE
Address2:  
City: NEW YORK
State: NY
PostalCode: 10029
CountryCode: US
TelephoneNumber: 2122418740
FaxNumber: 2129875584
Other Information
ProviderEnumerationDate: 03/22/2010
LastUpdateDate: 04/24/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X266068NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RR0500XMD044038DCY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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