Healthcare Provider Details

I. General information

NPI: 1235450966
Provider Name (Legal Business Name): EUGENE F. PALUSO MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 W CHESTNUT ST
WASHINGTON PA
15301-4657
US

IV. Provider business mailing address

380 W CHESTNUT ST
WASHINGTON PA
15301-4657
US

V. Phone/Fax

Practice location:
  • Phone: 724-228-0782
  • Fax: 724-228-7585
Mailing address:
  • Phone: 724-228-0782
  • Fax: 724-228-7585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD029870L
License Number StatePA

VIII. Authorized Official

Name: DR. EUGENE F PALUSO
Title or Position: PRESIDENT
Credential: MD
Phone: 724-228-0782