Healthcare Provider Details

I. General information

NPI: 1861582173
Provider Name (Legal Business Name): KAREN MARIE SANDER-BUSCEMI APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2006
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 WOODBRIDGE ST
SOUTH HADLEY MA
01075-1138
US

IV. Provider business mailing address

53 WOODBRIDGE ST
SOUTH HADLEY MA
01075-1138
US

V. Phone/Fax

Practice location:
  • Phone: 413-536-6306
  • Fax:
Mailing address:
  • Phone: 413-536-6306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number165091
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License Number165091
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: