Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 204900 | NY |
Y | 111NI0900X | Internist | 204900 | NY |
N | 207RA0401X | Internist - Addiction Medicine | 204900 | NY |
NPI | 1831113612 |
---|---|
Provider Name | Dr. Ricardo Orlando Dunner |
First Address | Bronxville, NY 10708-6454 |
Second Address | Bayside, NY 11361-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 27/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019364388 | (05) | NY |
204900 | LICENSE (01) | NY |
G75439 | (02) |