Healthcare Provider Details

I. General information

NPI: 1720098262
Provider Name (Legal Business Name): JEAN C BUHAC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 SEWARD ST
SARATOGA SPRINGS NY
12866-1143
US

IV. Provider business mailing address

6 BEAR BROOK CT
CLIFTON PARK NY
12065-2738
US

V. Phone/Fax

Practice location:
  • Phone: 518-581-2860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number210214-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: