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Individual

JESSE TAYLOR BUA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
175 JERICHO TPKE STE 216, SYOSSET, NY 11791-4538
(844) 443-2563
Mailing address
315 ATLANTIC AVE APT 2P, EAST ROCKAWAY, NY 11518-1103
(516) 330-7724

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
760094
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F407602-01
NY

Other

Enumeration date
09/13/2024
Last updated
03/16/2026
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