Healthcare Provider Details

I. General information

NPI: 1255271987
Provider Name (Legal Business Name): KATHLEEN BUZZEO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MILL ST
HANOVER MA
02339-1623
US

IV. Provider business mailing address

75 MILL ST
HANOVER MA
02339-1623
US

V. Phone/Fax

Practice location:
  • Phone: 617-952-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number021575
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: