Healthcare Provider Details

I. General information

NPI: 1558010710
Provider Name (Legal Business Name): AMBER ELAINE BULNA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 06/21/2025
Certification Date: 06/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 218
WASHINGTON DC
20010-2993
US

IV. Provider business mailing address

119 CREST DR
BELLEVILLE NJ
07109-2829
US

V. Phone/Fax

Practice location:
  • Phone: 202-525-2426
  • Fax:
Mailing address:
  • Phone: 973-405-0072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD600004226
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: