Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 046127 | NY |
NPI | 1508988635 |
---|---|
Provider Name | Carolyn Vanbuskirk |
First Address | Astoria, NY 11105 |
Second Address | New York, NY 10019-1628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 08/07/2007 |