Healthcare Provider Details

I. General information

NPI: 1134147937
Provider Name (Legal Business Name): PAULA J BUSSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 EAST 98TH STREET
NEW YORK NY
10029
US

IV. Provider business mailing address

BOX 3000 1 GUSTAVE L LEVY PLACE MOUNT SINAI DEPARTMENT OF MEDICI
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-0764
  • Fax: 212-534-0971
Mailing address:
  • Phone: 212-987-3100
  • Fax: 212-731-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number207453
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: