Provider Demographics
NPI:1225168040
Name:BUSBEY, SHAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAIL
Middle Name:
Last Name:BUSBEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PARK PL
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2826
Mailing Address - Country:US
Mailing Address - Phone:973-218-1191
Mailing Address - Fax:973-218-1191
Practice Address - Street 1:20 PARK PL
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2826
Practice Address - Country:US
Practice Address - Phone:973-218-1101
Practice Address - Fax:973-218-1101
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13608Medicare UPIN