Provider Demographics
NPI:1962684159
Name:BUZINOVER, ALLA B (DO)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:B
Last Name:BUZINOVER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4290 BROADWAY STE 2S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3732
Mailing Address - Country:US
Mailing Address - Phone:212-781-5100
Mailing Address - Fax:212-781-5329
Practice Address - Street 1:4290 BROADWAY STE 2S
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3732
Practice Address - Country:US
Practice Address - Phone:212-781-5100
Practice Address - Fax:212-781-5329
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY255180207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine