Provider Demographics
NPI:1548302821
Name:BHUSRI, AMIT (DC)
Entity type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:BHUSRI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BETHPAGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1515
Mailing Address - Country:US
Mailing Address - Phone:516-433-2058
Mailing Address - Fax:516-433-2058
Practice Address - Street 1:120 BETHPAGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1515
Practice Address - Country:US
Practice Address - Phone:516-433-2058
Practice Address - Fax:516-433-2058
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2919582OtherCIGNA PROVIDER ID
NY5898276OtherGHI PROVIDER ID
NYP2569808OtherOXFORD PROVIDER ID
NYX4O231Medicare ID - Type UnspecifiedPROVIDER NUMBER
NY2919582OtherCIGNA PROVIDER ID