Provider Demographics
NPI:1548204217
Name:BUSCHIAZZO, HORACIO J (MD)
Entity type:Individual
Prefix:DR
First Name:HORACIO
Middle Name:J
Last Name:BUSCHIAZZO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7807 OAK LANE RD
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1014
Mailing Address - Country:US
Mailing Address - Phone:215-635-5207
Mailing Address - Fax:215-635-5207
Practice Address - Street 1:7807 OAK LANE RD
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1014
Practice Address - Country:US
Practice Address - Phone:215-635-5207
Practice Address - Fax:215-635-5207
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2015-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD033769-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB36820Medicare UPIN