Bufalino, Russell S

Bufalino, Russell S is an sole proprietor health care provider with primary practice located at 313 S Main St , Old Forge PA 18518-1606. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, which is considered as his primary health care specialty. Bufalino, Russell S can be contacted via phone (570) 451-1122.

Contact Information

Primary practice address
313 S Main St Old Forge PA 18518-1606
Phone: (570) 451-1122
Fax: (570) 451-0541
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X MD008940E Pennsylvania

Profile Details

NPI number 1609836907
LBN Legal business name Bufalino, Russell S
Credentials M.D.,J.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2006
Last updated Mar 18th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609836907 NPPES
Pennsylvania Other 7289228 AETNA
Pennsylvania MEDICAID 1563559 AETNA
Pennsylvania Other BU108435 AETNA
Pennsylvania Other 817264 AETNA

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