Provider Demographics
NPI:1699040816
Name:BUSCEMI, NICHOLAS VINCENT (MSOM LAC)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:VINCENT
Last Name:BUSCEMI
Suffix:
Gender:M
Credentials:MSOM LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5225 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 402
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2014
Mailing Address - Country:US
Mailing Address - Phone:202-237-7000
Mailing Address - Fax:202-237-0017
Practice Address - Street 1:5225 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 402
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2014
Practice Address - Country:US
Practice Address - Phone:202-237-7000
Practice Address - Fax:202-237-0017
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist