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37 Main St Ste 1067 Sparta NJ 07871-1903 | |
| (718) 973-2401 | |
| (973) 786-4369 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 37 Main St Ste 1067, Sparta, New Jersey |
| Authorized Official Name and Position | Linda Busch (PSYCHOLOGIST) |
| Authorized Official Contact | 7184080407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
153 Dakota Dr Lafayette NJ 07848-4020 Ph: (718) 408-0407 | 37 Main St Ste 1067 Sparta NJ 07871-1903 Ph: (718) 973-2401 |
| NPI Number | 1720545650 |
|---|---|
| Provider Enumeration Date | 02/27/2019 |
| Last Update Date | 03/13/2019 |
| Medicare PECOS PAC ID | 6507106127 |
|---|---|
| Medicare Enrollment ID | O20190319000940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720545650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Linda E Busch Somach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205840584 PECOS PAC ID: 4688681034 Enrollment ID: I20140604000403 |
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