Provider Demographics
NPI:1972685675
Name:BURES, SERGIO (MD)
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:BURES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CARE MOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:111 BEDFORD RD
Practice Address - Street 2:CARE MOUNT MEDICAL PC
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2115
Practice Address - Country:US
Practice Address - Phone:914-232-3135
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201005207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02713326Medicaid
NY0667910001OtherDME
NYP00388700OtherMEDICARE RAILROAD
NYP00388700OtherMEDICARE RAILROAD
NY8V0751Medicare PIN