Provider Demographics
NPI:1396126504
Name:BUI, TIMOTHY (DPM)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E 84TH ST
Mailing Address - Street 2:APT# 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2931
Mailing Address - Country:US
Mailing Address - Phone:860-543-0190
Mailing Address - Fax:
Practice Address - Street 1:214 E 84TH ST
Practice Address - Street 2:APT# 5D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2931
Practice Address - Country:US
Practice Address - Phone:860-543-0190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP97174213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery