Individual
SUPINDA BUNYAVANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5 E 98TH ST, NEW YORK, NY 10029-6501
(212) 241-5548
Mailing address
5 E 98TH ST, NEW YORK, NY 10029-6501
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
265991
NY
207R00000X
Internal Medicine Physician
228887
MA
2080P0201X
Pediatric Allergy/Immunology Physician
265991
NY
Other
Enumeration date
07/10/2006
Last updated
04/26/2023
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