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General NPI Number Information
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NPI Number | 1205995180
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Entity Type | Individual
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Provider Name | ANTHONY J. CELLUCCI PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | EAST CAROLINA UNIVERSITY, 5TH STREET ECU PASS, RAWL BLD, 301
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City | GREENVILLE
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State | NC
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Zip | 27858
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Country | US
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Telephone | 252-737-4180
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Fax | 252-737-4166
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Provider Business Mailing Address
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Address Line | 231 CHURCHILL DR
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City | GREENVILLE
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State | NC
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Zip | 27858-8947
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Country | US
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Telephone | 252-702-3475
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 344
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License Number State | ID
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