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Individual

MR. KENNETH BUNTING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
435 LEWIS AVE, MERIDEN, CT 06451-2101
(203) 694-8200
Mailing address
160 ROXBURY RD, PLANTSVILLE, CT 06479-1458
(860) 628-9125

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
000275
CT
367500000X
Certified Registered Nurse Anesthetist
090463-23
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
430001068
CT
Enumeration date
09/24/2006
Last updated
03/01/2023
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