Provider Demographics
NPI:1144493982
Name:BUXBAUM, NATALIYA A (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIYA
Middle Name:A
Last Name:BUXBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NATALIYA
Other - Middle Name:
Other - Last Name:PROKOPENKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:615 FORT WASHINGTON AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3954
Mailing Address - Country:US
Mailing Address - Phone:609-456-9322
Mailing Address - Fax:
Practice Address - Street 1:ELM AND CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-8003
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243607208000000X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics