Provider Demographics
NPI:1699136762
Name:BUSER, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:BUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:GOCHUICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 MERWICK RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5730
Mailing Address - Country:US
Mailing Address - Phone:609-987-0099
Mailing Address - Fax:609-454-4886
Practice Address - Street 1:2995 CURRY ROAD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303
Practice Address - Country:US
Practice Address - Phone:609-987-0099
Practice Address - Fax:609-454-4886
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL-2681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist