Provider Demographics
NPI:1326307414
Name:BUSCEMI, JACQUELINE M (PT)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:M
Last Name:BUSCEMI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:6733 CURRAN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-6005
Mailing Address - Country:US
Mailing Address - Phone:703-448-0259
Mailing Address - Fax:703-448-0258
Practice Address - Street 1:6733 CURRAN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-6005
Practice Address - Country:US
Practice Address - Phone:703-448-0259
Practice Address - Fax:703-448-0258
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA23052073722251X0800X
NCP136302251X0800X
1206025722255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer