# MR. MARK J BUCCI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871095893
- **Gender:** Man
- **Credential:** C.P.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 222Z00000X | Orthotist | CO005782 | — | — |
| 224P00000X | Prosthetist | — | — | Yes |

## Other

- **Enumeration date:** 03/06/2018
- **Last updated:** 11/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CPO04410 | AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS, & PEDORTHICS | NC |