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General NPI Number Information
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NPI Number | 1437295342
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Entity Type | Organization
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Legal Business Name | DOCTORS PUN AND DELUCIA PC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 134 GRANDVIEW AVE SUITE 202
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City | WATERBURY
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State | CT
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Zip | 06708
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Country | US
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Telephone | 203-756-7788
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Fax | 203-754-1254
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Provider Business Mailing Address
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Address Line | 134 GRANDVIEW AVE SUITE 202
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City | WATERBURY
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State | CT
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Zip | 06708
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Country | US
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Telephone | 203-756-7788
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Fax | 203-754-1254
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Authorized Official
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Title or Position | HEAD PHYSICIAN
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Name | HECTOR R PUN
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Credential | MD
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Telephone | 203-756-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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