MEDICARE: ANTOINETTE S. BUNCHE MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	209041031	NY
2	174400000X	Specialist	982771001	NY

General Provider Information

NPI Number	:	1730448044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINETTE S. BUNCHE MS

Provider Business Mailing Address
First Line	:	2015 PITMAN AVE
Second Line	:	SUITE 3
City	:	BRONX
State	:	NY
Zip	:	10466-1918
Country	:	US
Telephone Number	:	347-964-7752
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 PITMAN AVE
Second Line	:	SUITE 3
City	:	BRONX
State	:	NY
Zip	:	10466-1918
Country	:	US
Telephone Number	:	347-964-7752
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	05/08/2012

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Directions to “ ANTOINETTE S. BUNCHE MS” Practice Location

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