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General NPI Number Information
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NPI Number | 1073523288
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Entity Type | Individual
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Provider Name | THOMAS D PULEO MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 5 MAIN ST STE 1
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City | LYME
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State | NH
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Zip | 03768-3500
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Country | US
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Telephone | 401-261-4875
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Fax |
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Provider Business Mailing Address
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Address Line | 594 HANOVER CENTER RD
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City | HANOVER
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State | NH
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Zip | 03755-4921
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Country | US
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Telephone | 401-261-4875
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD11592
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License Number State | RI
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