Healthcare Provider Details

I. General information

NPI: 1932496817
Provider Name (Legal Business Name): MARIA LOVELL BUNE PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 MANETTO HILL RD
PLAINVIEW NY
11803-1308
US

IV. Provider business mailing address

81 WICKS PATH
COMMACK NY
11725-4638
US

V. Phone/Fax

Practice location:
  • Phone: 516-931-2200
  • Fax:
Mailing address:
  • Phone: 631-455-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number381801
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: