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General NPI Number Information
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NPI Number | 1538611843
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Entity Type | Individual
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Provider Name | EMILY BUZZANCA ATC, LAT, EMT
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Gender | Female
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Dates
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Enumeration Date | 11/03/2016
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 1108 WHITNEY AVE
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City | HAMDEN
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State | CT
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Zip | 06517-3499
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Country | US
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Telephone | 203-230-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 315 YORK ST
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City | STRATFORD
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State | CT
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Zip | 06615-7958
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1145
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001145
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License Number State | CT
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