Individual
STEPHANUS BUSONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
77 VERONICA AVE STE 102, SOMERSET, NJ 08873-6804
(732) 246-1311
(732) 214-9657
Mailing address
77 VERONICA AVE STE 102, SOMERSET, NJ 08873-6804
(732) 246-1311
(732) 214-9657
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MA069235
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2342811
AETNA
NJ
01
—
P1626374
OXFORD
NJ
Enumeration date
06/11/2006
Last updated
12/03/2018
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