MEDICARE: DR. NEIL AMDUR BUSIS M.D.

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
1	2084N0400X	Neurology Physician	292147	NY
2	2084N0400X	Neurology Physician	MD033249E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407852999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL AMDUR BUSIS M.D.

Provider Business Mailing Address
First Line	:	222 E 41ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6739
Country	:	US
Telephone Number	:	212-263-7744
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 E 41ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6739
Country	:	US
Telephone Number	:	212-263-7744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	09/18/2023

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