MR. Diego Fernando Bustamante JR.

NPI #1053147272 in Shirley, New York

Provider Information

NPI Number: 1053147272
Entity Type: Individual
Name: MR. Diego Fernando Bustamante JR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 12, 2024
Last Updated: Sep 12, 2024

Practice Location

Address: 29 PARK AVE
City: Shirley
State: New York
ZIP Code: 11967-2338
Phone: (631) 569-0987

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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