MEDICARE: ONEKA DUNBAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	301039	NY

General Provider Information

NPI Number	:	1811449135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONEKA DUNBAR

Provider Business Mailing Address
First Line	:	1560 GRAND CONCOURSE
Second Line	:	104
City	:	BRONX
State	:	NY
Zip	:	10457-8402
Country	:	US
Telephone Number	:	347-755-3284
Fax Number	:

Provider Business Practice Location Address
First Line	:	1560 GRAND CONCOURSE
Second Line	:	104
City	:	BRONX
State	:	NY
Zip	:	10457-8402
Country	:	US
Telephone Number	:	347-755-3284
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2016
Last Update Date	:	11/03/2016

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