Individual
PATRICIO BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 47TH AVE, ALLIED MEDIX 2ND FLOOR, LONG ISLAND CITY, NY 11101-3013
(718) 593-4121
(718) 268-2646
Mailing address
6735B 186TH LN, 1B, FRESH MEADOWS, NY 11365-4402
(347) 302-5753
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
P90133
NY
Other
Enumeration date
10/17/2013
Last updated
10/17/2013
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