Individual
MR. GREGORY P. BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
100 SOUTHERN BLVD, NESCONSET, NY 11767-1749
(631) 361-8800
Mailing address
31 S HOWELL AVE, CENTEREACH, NY 11720-4327
(631) 672-2901
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021139
NY
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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