Individual
MR. CHRISTIAN BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
538 BROADHOLLOW RD STE 202, MELVILLE, NY 11747-3668
(631) 385-7780
(631) 385-7795
Mailing address
538 BROADHOLLOW ROAD, SUITE 202, MELVILLE, NY 11747
(631) 385-7780
(631) 385-7795
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
862344141
NY
Other
Enumeration date
06/27/2017
Last updated
07/21/2022
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