Individual
MATTHEW BUSHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
385 MAIN ST SOUTH, UNION SQUARE, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Mailing address
385 MAIN ST SOUTH, C/O NVRA IMAGING NETWORK UNION SQUARE BLDG #1, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
029230
CT
2085R0202X
Diagnostic Radiology Physician
Primary
029230
CT
2085U0001X
Diagnostic Ultrasound Physician
029230
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001292309
—
CT
01
—
300001215
MEDICARE ID
CT
01
—
300002551
MEDICARE ID
CT
01
—
300003215
MEDICARE ID
CT
Enumeration date
07/07/2006
Last updated
09/28/2015
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