Individual
MARY E BUSTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPOA
Contact information
Practice address
3416 JEROME AVE, BRONX, NY 10467-1002
(718) 325-3160
Mailing address
464 E 185TH ST # 1, BRONX, NY 10458-7704
(917) 232-1210
Taxonomy
Speciality
Code
Description
License number
State
156FX1201X
Optometric Assistant Technician
Primary
—
NY
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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