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NPI Code Detail

MEDICARE: DR. ANGELA B BUKSTEIN DDS

MEDICARE:  DR. ANGELA B BUKSTEIN  DDS
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry058393-1NY
2122300000XDentistD12874MN

General Provider Information

NPI Number : 1437478914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA B BUKSTEIN DDS
Provider Business Mailing Address
First Line : 209 W 104TH ST APT 4E
Second Line :
City : NEW YORK
State : NY
Zip : 10025-4235
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 86 W 225TH ST
Second Line :
City : BRONX
State : NY
Zip : 10463-7002
Country : US
Telephone Number : 201-308-8181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2010
Last Update Date : 03/12/2020

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Directions to “ DR. ANGELA B BUKSTEIN DDS” Practice Location

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