Provider Demographics
NPI:1992778674
Name:SUNDAY, BONNIE (MD)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:
Last Name:SUNDAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3065 SOUTHWESTERN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1239
Mailing Address - Country:US
Mailing Address - Phone:716-675-7443
Mailing Address - Fax:716-675-7465
Practice Address - Street 1:3065 SOUTHWESTERN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1239
Practice Address - Country:US
Practice Address - Phone:716-675-7443
Practice Address - Fax:716-675-7465
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-11
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01346689Medicaid
NY01346689Medicaid
BB1337Medicare ID - Type Unspecified