Provider Demographics
NPI:1508941295
Name:BUSE, DAWN C (PHD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:C
Last Name:BUSE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W 246TH ST
Mailing Address - Street 2:APT# 206
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3611
Mailing Address - Country:US
Mailing Address - Phone:718-405-8360
Mailing Address - Fax:718-405-8369
Practice Address - Street 1:MONTEFIORE HEADACHE CENTER
Practice Address - Street 2:1575 BLONDELL AVENUE STE 225
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-405-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16838103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist