Healthcare Provider Details

I. General information

NPI: 1942829767
Provider Name (Legal Business Name): WILLIAM CIURYLO B.S., M.A., D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2020
Last Update Date: 04/11/2020
Certification Date: 04/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BORTHWICK AVE
PORTSMOUTH NH
03801-7128
US

IV. Provider business mailing address

244 ROUTE 66
COLUMBIA CT
06237-1421
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-5110
  • Fax:
Mailing address:
  • Phone: 860-933-2549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: