Healthcare Provider Details

I. General information

NPI: 1528122728
Provider Name (Legal Business Name): ALITA BUZEL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 3RD AVE STE 2
NEW YORK NY
10128-3459
US

IV. Provider business mailing address

215 W 83RD ST APT 4G
NEW YORK NY
10024-4932
US

V. Phone/Fax

Practice location:
  • Phone: 212-799-1705
  • Fax:
Mailing address:
  • Phone: 212-874-4235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9127
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: