Provider Demographics
NPI:1659390128
Name:BUCHIERI, ROSS B (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:B
Last Name:BUCHIERI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SLATINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18080-1729
Mailing Address - Country:US
Mailing Address - Phone:610-767-2222
Mailing Address - Fax:610-767-3330
Practice Address - Street 1:856 MAIN ST
Practice Address - Street 2:
Practice Address - City:SLATINGTON
Practice Address - State:PA
Practice Address - Zip Code:18080-1729
Practice Address - Country:US
Practice Address - Phone:610-767-2222
Practice Address - Fax:610-767-3330
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007463L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01734709Medicaid
PA01734709Medicaid
PABU 022880Medicare ID - Type Unspecified