Provider Demographics
NPI:1669242830
Name:BUZZELLI, ANTHONY
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:BUZZELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 ALEX CT
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-7918
Mailing Address - Country:US
Mailing Address - Phone:724-996-0566
Mailing Address - Fax:
Practice Address - Street 1:1200 BROOKS LN STE 230
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3760
Practice Address - Country:US
Practice Address - Phone:412-460-8333
Practice Address - Fax:412-460-8334
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305126225100000X
PAPT031227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist