Individual
INGRID KAREN BUSTO GONZAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1907 OAK TREE RD STE 203, EDISON, NJ 08820-2070
(732) 662-5770
Mailing address
11 DEERWOOD AVE, EDISON, NJ 08817-3305
(347) 549-0957
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01303600
NJ
225100000X
Physical Therapist
9294
CO
Other
Enumeration date
01/29/2009
Last updated
05/17/2025
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