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General NPI Number Information
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NPI Number | 1669268173
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Entity Type | Individual
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Provider Name | BUSHRA WARDAK WHNP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2025
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 1010 NORTHERN BLVD STE 136
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City | GREAT NECK
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State | NY
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Zip | 11021-5306
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Country | US
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Telephone | 516-376-0747
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Fax |
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Provider Business Mailing Address
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Address Line | 103 WASHINGTON AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-3017
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Country | US
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Telephone | 516-661-1408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | F421731-01
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License Number State | NY
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