Marjuci Bukovac

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA012870 Issued in OH

Practice address

175 N Lake St
Amherst, OH 44001-1332

Phone

(440) 988-4415

NPI assigned

Mar 29, 2024

Last updated

Mar 29, 2024By the provider in NPPES

Sex

Female

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

State licenses

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1417708124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S LAKE ST",
            "city": "SOUTH AMHERST",
            "state": "OH",
            "postal_code": "440013014",
            "telephone_number": "440-381-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N LAKE ST",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011332",
            "telephone_number": "440-988-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKOVAC",
        "first_name": "MARJUCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA012870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Brown
• Heather Ann Bruderer, CNM
• Elizabeth A Bruot, LSW
• Ashley Victoria Bruzzese, DPT
• Addison Marie Buckholz
• Anastasia Dawn Burkes
• Shane Burnsworth
• Donna Burton
• Jennifer A Calabrese, MD
• Caleb Mental Health LLC

• Physical Therapy Assistant in Amherst, OH
• Providers in Amherst, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.