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General NPI Number Information
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NPI Number | 1275582181
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Entity Type | Organization
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Legal Business Name | EAST COAST WOUND CARE P C
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 976 MCLEAN AVE SUITE 387
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City | YONKERS
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State | NY
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Zip | 10704-4105
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Country | US
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Telephone | 914-237-6797
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Fax | 914-237-6790
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Provider Business Mailing Address
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Address Line | 976 MCLEAN AVE SUITE 387
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City | YONKERS
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State | NY
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Zip | 10704-4105
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Country | US
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Telephone | 914-237-6797
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Fax | 914-237-6790
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | CRAIG BUNKER
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Credential |
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Telephone | 914-237-6797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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