Provider Demographics
NPI:1780012336
Name:BUSCEMI, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BUSCEMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PEACHTREE CT
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9459
Mailing Address - Country:US
Mailing Address - Phone:856-381-9616
Mailing Address - Fax:
Practice Address - Street 1:323 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2034
Practice Address - Country:US
Practice Address - Phone:856-381-9616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00573100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health