Provider Demographics
NPI:1053629378
Name:BUENAVISTA, HAZEL RUMBAUA (MD)
Entity Type:Individual
Prefix:DR
First Name:HAZEL
Middle Name:RUMBAUA
Last Name:BUENAVISTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HAZEL
Other - Middle Name:BUENAVISTA
Other - Last Name:AQUINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2146 45TH RD
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4707
Mailing Address - Country:US
Mailing Address - Phone:718-392-4135
Mailing Address - Fax:
Practice Address - Street 1:3636 33RD ST STE 306
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-2329
Practice Address - Country:US
Practice Address - Phone:844-403-4325
Practice Address - Fax:424-625-0010
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258693207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine