Provider Demographics
NPI:1568840411
Name:BUZA, VITALY (MD)
Entity type:Individual
Prefix:MR
First Name:VITALY
Middle Name:
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 1:508 9TH AVE APT 4FN
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-2824
Mailing Address - Country:US
Mailing Address - Phone:716-341-4059
Mailing Address - Fax:
Practice Address - Street 1:565 ABBOTT ROAD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220
Practice Address - Country:US
Practice Address - Phone:716-826-7000
Practice Address - Fax:716-828-2700
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE33712207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease