Healthcare Provider Details

I. General information

NPI: 1346337862
Provider Name (Legal Business Name): RICHARD CIULLO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E GLOUCESTER PIKE
BARRINGTON NJ
08007-1323
US

IV. Provider business mailing address

45 ROCKVILLE DR
BELLMAWR NJ
08031-1134
US

V. Phone/Fax

Practice location:
  • Phone: 856-547-4422
  • Fax: 856-547-0660
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number40QA00916000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: