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General NPI Number Information
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NPI Number | 1831453562
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Entity Type | Individual
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Provider Name | JAMES DUSENBURY NPP
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Gender | Male
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 502 E TREMONT AVE
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City | BRONX
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State | NY
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Zip | 10457-4514
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Country | US
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Telephone | 347-250-2511
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Fax | 347-250-2512
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Provider Business Mailing Address
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Address Line | 3198 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10458-1000
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Country | US
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Telephone | 718-618-0401
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Fax | 718-795-4394
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 492397
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401612
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License Number State | NY
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