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NPI Code Detail

MEDICARE: DAMIAN LEE TERNULLO MD

MEDICARE: DAMIAN LEE TERNULLO MD
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
1208000000XPediatrics PhysicianMD431647PA
2208000000XPediatrics Physician319849NY

General Provider Information

NPI Number : 1538141080
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMIAN LEE TERNULLO MD
Provider Business Mailing Address
First Line : 107 INSTITUTE ST # NA
Second Line :
City : JAMESTOWN
State : NY
Zip : 14701-6628
Country : US
Telephone Number : 716-484-4334
Fax Number : 716-484-4334
Provider Business Practice Location Address
First Line : 107 INSTITUTE ST
Second Line :
City : JAMESTOWN
State : NY
Zip : 14701-6628
Country : US
Telephone Number : 716-484-4334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 04/03/2024

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