Individual
AGUSTIN BUSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
317 E 17TH ST, FIERMAN HALL 7TH FLOOR, NEW YORK, NY 10003
(212) 420-4198
Mailing address
PO BOX 95000-2433, PHILADELPHIA, PA 19195-2433
(212) 420-4198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
195814
NY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
195814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02148974
—
NY
Enumeration date
10/11/2005
Last updated
08/17/2012
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