Provider Demographics
NPI:1801419684
Name:BUSGITH, SAMANTHA ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ELIZABETH
Last Name:BUSGITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 55TH ST
Mailing Address - Street 2:FRNT 1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5586
Mailing Address - Country:US
Mailing Address - Phone:347-743-6774
Mailing Address - Fax:
Practice Address - Street 1:150 W 55TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5586
Practice Address - Country:US
Practice Address - Phone:212-991-6490
Practice Address - Fax:646-695-1011
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345900-01363LF0000X
NYF345900207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily