Individual
SERGIO RUSSO BUZZINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-0001
(570) 271-6440
(570) 271-6002
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD430784
PA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD430784
PA
2080S0010X
Pediatric Sports Medicine Physician
MD430784
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267437
—
SC
Enumeration date
08/29/2006
Last updated
06/23/2020
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