Provider Demographics
NPI:1760653331
Name:BUSBY, ALAN G (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:G
Last Name:BUSBY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:97 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1827
Mailing Address - Country:US
Mailing Address - Phone:646-924-6151
Mailing Address - Fax:201-244-5488
Practice Address - Street 1:97 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1827
Practice Address - Country:US
Practice Address - Phone:646-924-6151
Practice Address - Fax:201-244-5488
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2014-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00605500152W00000X
NYT-006457152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist