MEDICARE: DR. NAHNDI BUSH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MA66285	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568504280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAHNDI BUSH M.D.

Provider Business Mailing Address
First Line	:	1016 MAIN AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-2327
Country	:	US
Telephone Number	:	973-546-5700
Fax Number	:	973-546-8898

Provider Business Practice Location Address
First Line	:	40 UNION AVE
Second Line	:	SUITE 102
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3277
Country	:	US
Telephone Number	:	973-399-6270
Fax Number	:	973-374-3346

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	02/02/2017

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