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NPI Code Detail

MEDICARE: TANJANIKA BUSTER

MEDICARE: TANJANIKA BUSTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerF404212-01NY

General Provider Information

NPI Number : 1306561873
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANJANIKA BUSTER
Provider Business Mailing Address
First Line : 2 ACADEMY ST RM 201
Second Line :
City : MAYVILLE
State : NY
Zip : 14757-1050
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 60 FRANKLIN AVE
Second Line :
City : DUNKIRK
State : NY
Zip : 14048-2804
Country : US
Telephone Number : 716-363-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2022
Last Update Date : 03/06/2024

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Directions to “ TANJANIKA BUSTER ” Practice Location

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