Provider Demographics
NPI:1164488813
Name:BUCCHIERI, ELIZABETH Z (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:Z
Last Name:BUCCHIERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 SOUTH GREEN ROAD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121
Mailing Address - Country:US
Mailing Address - Phone:216-291-9210
Mailing Address - Fax:216-291-9422
Practice Address - Street 1:2054 SOUTH GREEN ROAD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121
Practice Address - Country:US
Practice Address - Phone:216-291-9210
Practice Address - Fax:216-291-9422
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078270208000000X
OH3507827208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2221367Medicaid
OH2221367Medicaid