Healthcare Provider Details

I. General information

NPI: 1336533611
Provider Name (Legal Business Name): DR. DEBORA BUZINKAI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 AVENUE B
BAYONNE NJ
07002-2020
US

IV. Provider business mailing address

168 AVENUE B
BAYONNE NJ
07002-2020
US

V. Phone/Fax

Practice location:
  • Phone: 201-725-2871
  • Fax:
Mailing address:
  • Phone: 201-725-2871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number37PC00358900
License Number StateNJ

VIII. Authorized Official

Name: DR. DEBORA BUZINKAI
Title or Position: OWNER
Credential: PSYD
Phone: 201-725-2871