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Individual

CARY D BUCKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
263 7TH AVE, BROOKLYN, NY 11215
(718) 246-8614
(718) 246-8656
Mailing address
PO BOX 7490, SHREWSBURY, NJ 07702
(718) 246-8614
(718) 246-8656

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
202974
NY
2084N0400X
Neurology Physician
49880
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01952221
NY
05
300002093
IN
05
7100484770
KY
Enumeration date
03/14/2006
Last updated
11/08/2017
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