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General NPI Number Information
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NPI Number | 1225690472
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Entity Type | Individual
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Provider Name | MISS KRISTEN BUSCH
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Gender | Female
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 9822 ROUTE 16
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City | MACHIAS
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State | NY
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Zip | 14101-9771
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Country | US
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Telephone | 716-353-8516
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Fax |
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Provider Business Mailing Address
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Address Line | 8 HIDDEN TRL
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City | LANCASTER
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State | NY
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Zip | 14086-9684
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Country | US
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Telephone | 716-949-9419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 021169
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License Number State | NY
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