Provider Demographics
NPI:1528313020
Name:BUNSE, BREE MICHELLE
Entity type:Individual
Prefix:MRS
First Name:BREE
Middle Name:MICHELLE
Last Name:BUNSE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BREE
Other - Middle Name:MICHELLE
Other - Last Name:DISCHLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 BEGONIA RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9535
Mailing Address - Country:US
Mailing Address - Phone:631-821-3784
Mailing Address - Fax:
Practice Address - Street 1:23 BEGONIA RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9535
Practice Address - Country:US
Practice Address - Phone:631-821-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist