Individual
CHRIS BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
44 E 12TH ST APT MD1, NEW YORK, NY 10003-4667
(212) 206-1501
Mailing address
44 E 12TH ST APT MD1, NEW YORK, NY 10003-4667
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
782019-01
NY
363L00000X
Nurse Practitioner
Primary
347842
NY
Other
Enumeration date
02/05/2020
Last updated
07/01/2021
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