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General NPI Number Information
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NPI Number | 1356344527
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Entity Type | Individual
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Provider Name | MARK A TULECKE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 1 HAMPTON RD UNIT 208
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City | EXETER
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State | NH
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Zip | 03833-4849
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Country | US
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Telephone | 603-778-8522
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Fax | 603-778-1602
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Provider Business Mailing Address
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Address Line | PO BOX 100519
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City | ATLANTA
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State | GA
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Zip | 30384-0519
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Country | US
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Telephone | 888-208-6228
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Fax | 603-778-1602
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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 | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 11886
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 155848
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 11886
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 155848
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License Number State | MA
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