Individual
EVERICK AYALA-BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
(718) 991-4516
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
267626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
267626
LICENSE
NY
Enumeration date
01/16/2013
Last updated
07/10/2019
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