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Individual

MR. JAMES DUSENBURY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NPP

Contact information

Practice address
502 E TREMONT AVE, BRONX, NY 10457-4514
(347) 250-2511
(347) 250-2512
Mailing address
3198 GRAND CONCOURSE, BRONX, NY 10458-1000
(718) 618-0401
(718) 795-4394

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
492397
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401612
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03687845
NY
Enumeration date
06/27/2012
Last updated
05/19/2014
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