Healthcare Provider Details

I. General information

NPI: 1508387366
Provider Name (Legal Business Name): ANTHONY BUETI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27003 HILLSIDE AVE
NEW HYDE PARK NY
11040-2517
US

IV. Provider business mailing address

132 SWAN LN
LEVITTOWN NY
11756-4437
US

V. Phone/Fax

Practice location:
  • Phone: 718-831-1900
  • Fax:
Mailing address:
  • Phone: 914-400-4183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number040219
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number040219
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: