Provider Demographics
NPI:1346685690
Name:BUZZELLI, JULIE A (LMT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:BUZZELLI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WOODSWAY RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2024
Mailing Address - Country:US
Mailing Address - Phone:818-957-2185
Mailing Address - Fax:
Practice Address - Street 1:11 WOODSWAY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2024
Practice Address - Country:US
Practice Address - Phone:818-957-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMC-T000112171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor