Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. THEODORE A BUCCILLI JR., DPM
Active Sole ProprietorDR. THEODORE A BUCCILLI JR., DPM is a Podiatrist healthcare provider located in RAVENNA, Ohio. NPI 1164413019 is currently active in the NPPES registry. Verify at CMS.
Podiatrist · RAVENNA, OH
Registration Details
- NPI Number
- 1164413019
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 31, 2005 (20.786488464109 yrs)
- Last Updated
- Aug 15, 2025
- License
-
36003352 (OH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4403 CLOVER DRRAVENNA, OH, 442668636Browse OH providers · Browse ZIP 44266
- Phone
- 3306877464
- Primary Specialty
-
Podiatrist
213E00000X
Other Podiatrist Providers in RAVENNA, OH
| Name | Credential | NPI |
|---|---|---|
| ERIC J PAUL | DPM | 1013979970 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.