MEDICARE: DR. JOSE ANGELO ARAULLO DE DIOS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	48679	CT

General Provider Information

NPI Number	:	1124227020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE ANGELO ARAULLO DE DIOS M.D.

Provider Business Mailing Address
First Line	:	79 WAWECUS ST STE 103
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-2173
Country	:	US
Telephone Number	:	860-886-1862
Fax Number	:	860-886-2046

Provider Business Practice Location Address
First Line	:	79 WAWECUS ST STE 103
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-2173
Country	:	US
Telephone Number	:	860-886-1862
Fax Number	:	860-886-2046

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	11/03/2023

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