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General NPI Number Information
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NPI Number | 1407705510
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Entity Type | Organization
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Legal Business Name | MARIEL BUQUE PH.D. PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 21 LEXINGTON AVE
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-5715
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Country | US
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Telephone | 407-212-7768
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Fax |
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Provider Business Mailing Address
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Address Line | 442 LORIMER ST STE D
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City | BROOKLYN
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State | NY
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Zip | 11206-1030
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIEL BUQUE
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Credential | PH.D.
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Telephone | 973-519-5033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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