Provider Demographics
NPI:1225870223
Name:NAZAIRE, BUNETTE
Entity type:Individual
Prefix:
First Name:BUNETTE
Middle Name:
Last Name:NAZAIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 COLONIAL ARMS RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7608
Mailing Address - Country:US
Mailing Address - Phone:908-265-2101
Mailing Address - Fax:
Practice Address - Street 1:692 COLONIAL ARMS RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7608
Practice Address - Country:US
Practice Address - Phone:908-265-2101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15960400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health