Healthcare Provider Details

I. General information

NPI: 1467195438
Provider Name (Legal Business Name): SHAYNA ANN BUZZELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 TOWER RD STE A
DENVER CO
80249-7381
US

IV. Provider business mailing address

18563 E 47TH AVE
DENVER CO
80249-7764
US

V. Phone/Fax

Practice location:
  • Phone: 303-406-9550
  • Fax:
Mailing address:
  • Phone: 954-990-9990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: