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Individual

MS. MARY GUNDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CDE

Contact information

Practice address
242 MASON AVE, DIABETES EDUCATION - 1ST FLOOR, STATEN ISLAND, NY 10305-3408
(718) 226-1547
(718) 226-1438
Mailing address
242 MASON AVE, DIABETES EDUCATION - 1ST FLOOR, STATEN ISLAND, NY 10305-3408
(718) 226-1547
(718) 226-1438

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
0942-0278
NY
163WD0400X
Diabetes Educator Registered Nurse
Primary
385302-1
NY

Other

Enumeration date
11/13/2009
Last updated
11/13/2009
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