Provider Demographics
NPI:1750900940
Name:BUCZKO, AARON MICHAEL (NP-C)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:MICHAEL
Last Name:BUCZKO
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 RANGER DR
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43619-2050
Mailing Address - Country:US
Mailing Address - Phone:419-973-2924
Mailing Address - Fax:
Practice Address - Street 1:4098 RANGER DR
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43619-2050
Practice Address - Country:US
Practice Address - Phone:419-973-2924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.026143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily