Individual
JONATHAN MICHAEL BUSCAGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 TECHNOLOGY DRIVE, STONY BROOK UNIVERSITY PHYSICIANS, EAST SETAUKET, NY 11733
(631) 444-5220
(631) 444-5225
Mailing address
3 TECHNOLOGY DRIVE, STONY BROOK UNIVERSITY PHYSICIANS, EAST SETAUKET, NY 11733
(631) 444-5220
(631) 444-5225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0063684
MD
207RG0100X
Gastroenterology Physician
Primary
D63684
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
409447600
—
MD
Enumeration date
05/10/2006
Last updated
07/03/2008
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