Philip Buzzerio, M.S. ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000016993

Practice address

1925 Giants Dr
East Rutherford, NJ 07073-2140

Phone

(201) 403-1513

NPI assigned

Jun 15, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1013367408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ADDISON AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702303",
            "telephone_number": "201-403-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 GIANTS DR",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070732140",
            "telephone_number": "201-403-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZZERIO",
        "first_name": "PHILIP",
        "credential": "M.S. ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000016993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in East Rutherford, NJ
• Providers in East Rutherford, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.