Healthcare Provider Details

I. General information

NPI: 1770496424
Provider Name (Legal Business Name): LAURA A BUDDENBERG HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA STOLTZ

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 BLACKLICK EASTERN RD STE 700
PICKERINGTON OH
43147-7878
US

IV. Provider business mailing address

580 HOWARD AVE
SOMERSET NJ
08873-1113
US

V. Phone/Fax

Practice location:
  • Phone: 614-694-4423
  • Fax: 614-694-4506
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberIL.03612
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: