Individual
DR. MARIA J BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1258 6TH AVE, NEW YORK, NY 10020-1511
(503) 705-7755
Mailing address
1258 6TH AVE, NEW YORK, NY 10020-1511
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV009808-01
NY
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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