Individual provider Active NPI

Luz Torres Bustamante

  • Student in an Organized Health Care Education/Training Program
  • Bergenfield, NJ
National Provider Identifier
1225453723
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
67 Garden St
Bergenfield, NJ 07621-2743
Phone
(551) 655-5630
NPI assigned
Feb 20, 2014
Last updated
Jan 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Speech-Language Pathologist 235Z00000X 024469 NY

Addresses

Primary practice location

67 Garden St
Bergenfield, NJ 07621-2743

Mailing address

67 Garden St
Bergenfield, NJ 07621-2743
Phone (551) 655-5630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
024469NYMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1225453723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 GARDEN ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212743",
            "telephone_number": "551-655-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 GARDEN ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212743",
            "telephone_number": "551-655-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES BUSTAMANTE",
        "first_name": "LUZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "024469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bergenfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.