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General NPI Number Information
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NPI Number | 1427265941
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Entity Type | Individual
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Provider Name | GREGORY BUNKLEY
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 254 E MAIN ST
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City | NEWARK
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State | DE
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Zip | 19711-7311
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Country | US
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Telephone | 302-731-1504
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Fax | 302-731-2720
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Provider Business Mailing Address
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Address Line | 1418 S FARMVIEW DR
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City | DOVER
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State | DE
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Zip | 19904-3390
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Country | US
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Telephone | 610-363-1488
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Fax | 610-363-8273
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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