Provider Demographics
NPI:1568905933
Name:NICHOLAS V BUSCEMI MSOM LAC
Entity Type:Organization
Organization Name:NICHOLAS V BUSCEMI MSOM LAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:BUSCEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MSOM
Authorized Official - Phone:503-962-0986
Mailing Address - Street 1:2232 WASHINGTON AVE
Mailing Address - Street 2:APT 201
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2638
Mailing Address - Country:US
Mailing Address - Phone:503-962-0986
Mailing Address - Fax:
Practice Address - Street 1:3000 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 334
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2509
Practice Address - Country:US
Practice Address - Phone:503-962-0986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty