| Doctor Name: | DR. SANGA BUNYAVANICH |
| NPI Number: | 1992096259 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 114997 |
| Business Practice Address: | 6200 Beach Channel Dr Arverne, NY - 116921409 |
| Business Phone Number: | 7189457150 |
| Business Fax Number: | 7186636133 |
| Mailing Address: | 6200 Beach Channel Dr, ARVERNE |
| State: | NY |
| Postal Code: | 116921409 |
| Phone Number: | 7189457150 |
| Fax Number: | 7186636133 |
| NPI Enumeration Date: | 04/21/2011 |
| NPI Last Update Date: | 02/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 114997 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |