Healthcare Provider Details

I. General information

NPI: 1700767860
Provider Name (Legal Business Name): SAMANTHA ANN BUZALEWSKI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1872 ST LUKES BLVD
EASTON PA
18045-5669
US

IV. Provider business mailing address

93 CASSEL RD
READING PA
19606-9486
US

V. Phone/Fax

Practice location:
  • Phone: 866-785-8537
  • Fax:
Mailing address:
  • Phone: 484-336-7409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA067009
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: