Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 242654 | NY |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 242654 | NY |
NPI | 1144409269 |
---|---|
Provider Name | Dr. Thomas Bustros |
First Address | Brooklyn, NY 11209-1204 |
Second Address | Brooklyn, NY 11209-1204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2007 |
Last Update Date | 01/12/2021 |