Individual
DR. BRUCE L. KUNTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1780 HANSHAW RD, ITHACA, NY 14850-9105
(607) 257-5858
(607) 257-1718
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
208587
NY
207Q00000X
Family Medicine Physician
Primary
208587-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017413740003
—
PA
05
—
02223403
—
NY
01
—
080182608
RR MEDICARE PIN
NY
01
—
CC8362
RR MEDICARE GROUP
NY
Enumeration date
03/14/2006
Last updated
03/28/2021
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