Provider Demographics
NPI:1184433401
Name:BUSURI, NIHAAL
Entity type:Individual
Prefix:
First Name:NIHAAL
Middle Name:
Last Name:BUSURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-1739
Mailing Address - Country:US
Mailing Address - Phone:614-598-9716
Mailing Address - Fax:
Practice Address - Street 1:1161 MILLER AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-1739
Practice Address - Country:US
Practice Address - Phone:614-598-9716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage