Healthcare Provider Details

I. General information

NPI: 1720242910
Provider Name (Legal Business Name): CHRISTINE BUSCAINO HOLZINGER MA,CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE BUSCAINO SMITH MA,CCC-A

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 STATE RT 23 SUITE 2
RIVERDALE NJ
07457-1625
US

IV. Provider business mailing address

51 STATE RT 23 SUITE 2
RIVERDALE NJ
07457-1625
US

V. Phone/Fax

Practice location:
  • Phone: 973-831-1220
  • Fax: 973-831-0029
Mailing address:
  • Phone: 973-831-1220
  • Fax: 973-831-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00000900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number25MG00044400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number25MG00044400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: