Healthcare Provider Details

I. General information

NPI: 1912759218
Provider Name (Legal Business Name): JEFFREY BUCY RRT-NPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 RIDGEWOOD BLVD
BELPRE OH
45714-8224
US

IV. Provider business mailing address

440 RIDGEWOOD BLVD
BELPRE OH
45714-8224
US

V. Phone/Fax

Practice location:
  • Phone: 740-706-2259
  • Fax:
Mailing address:
  • Phone: 740-706-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRCP-13396
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: