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NPI Code Detail

MEDICARE: TIMOTHY ROBERT BUZBY LCSW

MEDICARE: TIMOTHY ROBERT BUZBY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW025920PA

General Provider Information

NPI Number : 1982350302
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY ROBERT BUZBY LCSW
Provider Business Mailing Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-823-5800
Fax Number :
Provider Business Practice Location Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-823-5800
Fax Number : 215-823-6392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2022
Last Update Date : 12/17/2025

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