Individual
TERESITA GUNGON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
253 MAIN ST, DANSVILLE, NY 14437-1111
(585) 335-2296
(585) 335-2299
Mailing address
253 MAIN ST, DANSVILLE, NY 14437-1111
(585) 335-2296
(585) 335-2299
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
110602
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00051134001
UNIVERA
NY
05
—
00468153
—
NY
01
—
0086371
GROUP HEALTH INCORPORATED
NY
01
—
1012176CK
PREFERRED CARE
NY
01
—
2837
BLUE SHIELD OF ROCHESTER
NM
01
—
5174022
AETNA
NY
Enumeration date
05/01/2006
Last updated
07/08/2007
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