Healthcare Provider Details

I. General information

NPI: 1063894749
Provider Name (Legal Business Name): CHRISTOPHER ROBERT BUZAS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 STERRETTANIA RD LOWR LEVEL
ERIE PA
16506-4125
US

IV. Provider business mailing address

1 LECOM PL
ERIE PA
16505-2571
US

V. Phone/Fax

Practice location:
  • Phone: 814-836-0543
  • Fax: 814-838-1145
Mailing address:
  • Phone: 814-868-2507
  • Fax: 814-868-2522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOS019757
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOT016521
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: