Healthcare Provider Details

I. General information

NPI: 1376727941
Provider Name (Legal Business Name): RICHARD MICHAEL ZUNIGA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 E MAIN ST STE 1
BABYLON NY
11702-3526
US

IV. Provider business mailing address

1 RESEARCH RD
RIDGE NY
11961-2701
US

V. Phone/Fax

Practice location:
  • Phone: 631-751-3000
  • Fax:
Mailing address:
  • Phone: 631-751-3000
  • Fax: 978-788-7966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberP0689
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number263890
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number266882
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: