Healthcare Provider Details

I. General information

NPI: 1457756926
Provider Name (Legal Business Name): BHUVANA SUNIL M.B.B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 LENOX AVE MLK 17TH FLOOR
NEW YORK NY
10037-1802
US

IV. Provider business mailing address

620 LENOX AVE APT 12 R
NEW YORK NY
10037-1204
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-4019
  • Fax:
Mailing address:
  • Phone: 205-243-7697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: