1578485702 NPI number — MRS. NINA PATRICIA ROBERTSON BUSCONE

Table of content: MRS. NINA PATRICIA ROBERTSON BUSCONE (NPI 1578485702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578485702 NPI number — MRS. NINA PATRICIA ROBERTSON BUSCONE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUSCONE
Provider First Name:
NINA
Provider Middle Name:
PATRICIA ROBERTSON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBERTSON
Provider Other First Name:
NINA
Provider Other Middle Name:
PATRICIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578485702
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
658 E 6TH ST APT 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02127-3133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-505-5570
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEEDHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02494-3023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-449-1884
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP100938 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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