Healthcare Provider Details

I. General information

NPI: 1316318884
Provider Name (Legal Business Name): UNOCARE MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 SOUTHERN BLVD
BRONX NY
10459-5202
US

IV. Provider business mailing address

811 SOUTHERN BLVD
BRONX NY
10459-5202
US

V. Phone/Fax

Practice location:
  • Phone: 917-801-1141
  • Fax: 917-801-1144
Mailing address:
  • Phone: 917-801-1141
  • Fax: 917-801-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number204900
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number204900
License Number StateNY

VIII. Authorized Official

Name: RICARDO O DUNNER
Title or Position: CEO
Credential: M.D
Phone: 917-801-1141