Individual
DR. MYRNA K. NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
227 FRANKLIN AVE, HEWLETT, NY 11557-1902
(516) 295-5500
(516) 569-8225
Mailing address
545 ELMONT RD, ELMONT, NY 11003-4002
(516) 354-4200
(516) 775-1972
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
157104
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01967477
—
NY
Enumeration date
12/29/2005
Last updated
12/22/2011
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