MR. CHRISTOPHER BUSAPAVANIJ


Address: 152 Broadway, Brooklyn, NY 11211-8767
Phone: 2123853700

MR. CHRISTOPHER BUSAPAVANIJ (NPI# 1952589814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952589814
Entity Type Individual
Full Name MR. CHRISTOPHER BUSAPAVANIJ
Credential PA-C
Practice Address 152 Broadway
Brooklyn
NY 11211-8767
Practice Telephone 2123853700
Practice Fax Number 2123853703
Mailing Telephone 2123853700
Enumeration Date 2008-02-03
Last Update Date 2016-05-24
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
012317 NY Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 152 BROADWAY
City BROOKLYN
State NY
Zip Code 11211-8767

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NPI Name Taxonomy Address Enumeration
1477016988 Holly Maire Dimura Physician Assistant 152 Broadway, Brooklyn, NY 11211-8767 2019-04-11

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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

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Competitor

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City BROOKLYN
Zip Code 11211

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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