Healthcare Provider Details

I. General information

NPI: 1184639056
Provider Name (Legal Business Name): CAROL BUES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 W 57TH ST APT 1C
NEW YORK NY
10019-3002
US

IV. Provider business mailing address

448 W 57TH ST APT 1C
NEW YORK NY
10019-3002
US

V. Phone/Fax

Practice location:
  • Phone: 212-757-9407
  • Fax:
Mailing address:
  • Phone: 212-757-9407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number000992
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: