Healthcare Provider Details

I. General information

NPI: 1730005554
Provider Name (Legal Business Name): MR. SALVATORE G BUCCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8605 WINDSOR WAY
BROADVIEW HTS OH
44147-1796
US

IV. Provider business mailing address

8605 WINDSOR WAY
BROADVIEW HEIGHTS OH
44147-1796
US

V. Phone/Fax

Practice location:
  • Phone: 216-570-0360
  • Fax:
Mailing address:
  • Phone: 216-570-0360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: