Pezzullo, Christopher

Pezzullo, Christopher is an individual health care provider with primary practice located at 295 Forest Ave 2Nd Floor, Portland ME 04101-2018. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Pezzullo, Christopher can be contacted via phone (207) 772-5437.

Contact Information

Primary practice address
295 Forest Ave 2Nd Floor Portland ME 04101-2018
Phone: (207) 772-5437
Fax: (207) 879-1537
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 1505 Maine

Profile Details

NPI number 1417933060
LBN Legal business name Pezzullo, Christopher
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Jun 24th, 2016 - about 10 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 1417933060 NPPES
Maine MEDICAID 293660099

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