Provider Demographics
NPI:1528439692
Name:BUNT-GARDNER, CYNTHIA (RPH)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:BUNT-GARDNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-3306
Mailing Address - Country:US
Mailing Address - Phone:914-482-5170
Mailing Address - Fax:
Practice Address - Street 1:732 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-3306
Practice Address - Country:US
Practice Address - Phone:914-482-5170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist