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General NPI Number Information
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NPI Number | 1750529897
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Entity Type | Organization
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Legal Business Name | MARIA C BUCCO, DO, PC
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 1088 W BALTIMORE PIKE HEALTH CARE CENTER II SUITE 2104
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City | MEDIA
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State | PA
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Zip | 19063-5146
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Country | US
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Telephone | 610-744-2980
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Fax | 610-744-2982
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Provider Business Mailing Address
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Address Line | 1088 W BALTIMORE PIKE HEALTH CARE CENTER II SUITE 2104
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City | MEDIA
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State | PA
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Zip | 19063-5146
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Country | US
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Telephone | 610-744-2980
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Fax | 610-744-2982
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA CAMILLA BUCCO
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Credential | DO
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Telephone | 610-744-2980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | OS006967L
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License Number State | PA
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