Most Relevant Information
Provider Data
| NPI Number: | 1003390881 |
| Provider Name: | LIDA BUNIAK MASTER OF SCIENCE |
| Entity Type: | Individual |
| Taxonomy Code: | 103TS0200X |
| Specialty: | Psychologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/18/2018 |
| Last Updated: | 09/18/2018 |
Provider Practice Location
10 BURKLE ST
OSWEGO
NY
131263259
Practice Location Phone/Fax
| Phone: | 3153424600 |
| Fax: |
Provider Mailing Location
7100 CORONATION CIR
FAYETTEVILLE
NY
130668723
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |