Provider Demographics
NPI:1831158773
Name:BUZINKAI, PATRICIA A (PA-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:BUZINKAI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:16 CHURCH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-1136
Practice Address - Country:US
Practice Address - Phone:570-675-2111
Practice Address - Fax:570-675-6545
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003603L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP44057Medicare UPIN
PA052756PHBMedicare ID - Type Unspecified