Provider Demographics
NPI:1154364446
Name:BUZA, DORU ION (MD)
Entity type:Individual
Prefix:DR
First Name:DORU
Middle Name:ION
Last Name:BUZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60-83 MYRTLE AV
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385
Mailing Address - Country:US
Mailing Address - Phone:718-628-1010
Mailing Address - Fax:718-380-0235
Practice Address - Street 1:6083 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5908
Practice Address - Country:US
Practice Address - Phone:718-628-1010
Practice Address - Fax:718-380-0235
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194378207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01267Medicare ID - Type Unspecified