Theodore a Buccilli Jr Dpm

NPI #1528024619 in Tallmadge, Ohio

Provider Information

NPI Number: 1528024619
Entity Type: Organization
Organization Name: Theodore a Buccilli Jr Dpm
Primary Specialty: Podiatrist
Enumeration Date: Apr 26, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 116 EAST AVE
City: Tallmadge
State: Ohio
ZIP Code: 44278-2328
Phone: (330) 633-3445

Authorized Official

Name: SUSAN CERIMELE
Title: BILLING
Phone: (330) 633-3445

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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