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General NPI Number Information
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NPI Number | 1104354935
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Entity Type | Individual
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Provider Name | IMRAN RAFI AHMED PUNEKAR MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2017
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 626 1ST AVE APT W45G
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City | NEW YORK
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State | NY
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Zip | 10016-3950
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Country | US
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Telephone | 585-754-6668
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Fax |
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Provider Business Mailing Address
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Address Line | 626 1ST AVE APT W45G
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City | NEW YORK
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State | NY
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Zip | 10016-3950
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Country | US
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Telephone | 585-754-6668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 311090
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 311090
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License Number State | NY
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