Individual
LISA BUNCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
104 SEVENTY ACRE RD, REDDING, CT 06896-2706
(203) 938-0492
Mailing address
104 SEVENTY ACRE RD, REDDING, CT 06896-2706
(203) 938-0492
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000195
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013881
US HEALTH CARE PROVIDER #
CT
01
—
270000195CT01
BCBS PROVIDER #
CT
01
—
4488171
AETNA HEALTH PROVIDER #
CT
01
—
P818135
OXFORD HEALTH PROVIDER #
CT
Enumeration date
10/11/2006
Last updated
07/08/2007
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