Provider Demographics
NPI:1285441170
Name:BIZUB, ANNE (PHD, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BIZUB
Suffix:
Gender:
Credentials:PHD, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SHELBY ST STE 212
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-1163
Mailing Address - Country:US
Mailing Address - Phone:888-721-3003
Mailing Address - Fax:
Practice Address - Street 1:525 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1606
Practice Address - Country:US
Practice Address - Phone:888-721-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71016511A363LP0808X
NJ26NJ15192100103TC0700X, 163WP0808X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult