Healthcare Provider Details

I. General information

NPI: 1629012265
Provider Name (Legal Business Name): DAVID BUSHINSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-4517
  • Fax: 585-442-9201
Mailing address:
  • Phone: 585-275-1554
  • Fax: 585-276-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number178053
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: