MEDICARE: JEAN C BUHAC MD

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	207N00000X	Dermatology Physician	210214-1	NY

General Provider Information

NPI Number	:	1720098262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN C BUHAC MD

Provider Business Mailing Address
First Line	:	6 BEAR BROOK CT
Second Line	:
City	:	CLIFTON PARK
State	:	NY
Zip	:	12065-2738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 SEWARD ST
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-1143
Country	:	US
Telephone Number	:	518-581-2860
Fax Number	:

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	10/04/2012

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