Healthcare Provider Details

I. General information

NPI: 1740458173
Provider Name (Legal Business Name): MARKO BUKUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE BELLEVUE HOSPITAL CENTER NBV 15 S 14
NEW YORK NY
10016-9196
US

IV. Provider business mailing address

462 1ST AVE BELLEVUE HOSPITAL CENTER NBV 15 S 14
NEW YORK NY
10016-9196
US

V. Phone/Fax

Practice location:
  • Phone: 212-562-3917
  • Fax:
Mailing address:
  • Phone: 212-562-3917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number9441191
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberA102760
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberME115740
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: