Healthcare Provider Details

I. General information

NPI: 1154906279
Provider Name (Legal Business Name): ELIZABETH ANNE BUZBEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 BROAD ST
NEW YORK NY
10004-2400
US

IV. Provider business mailing address

230 W 55TH ST APT 7H
NEW YORK NY
10019-5211
US

V. Phone/Fax

Practice location:
  • Phone: 212-385-3030
  • Fax:
Mailing address:
  • Phone: 713-494-4628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: