MEDICARE: MR. PAUL A ULLUCCI JR. DPT, PHD, ATC, SCS

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	225100000X	Physical Therapist	948	RI
2	2251S0007X	Sports Physical Therapist	948	RI
3	2251X0800X	Orthopedic Physical Therapist	9020	MA

General Provider Information

NPI Number	:	1942261300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL A ULLUCCI JR. DPT, PHD, ATC, SCS

Provider Business Mailing Address
First Line	:	572 OLD SOMERSET AVE
Second Line	:
City	:	NORTH DIGHTON
State	:	MA
Zip	:	02764-1824
Country	:	US
Telephone Number	:	401-487-3582
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 OLD SOMERSET AVE
Second Line	:
City	:	NORTH DIGHTON
State	:	MA
Zip	:	02764-1866
Country	:	US
Telephone Number	:	508-822-1135
Fax Number	:	508-822-4115

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	03/18/2025

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