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General NPI Number Information
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NPI Number | 1578526877
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Entity Type | Individual
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Provider Name | LUIGI G TULLO MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 133-03 JAMAICA AVE
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City | RICHMOND HILL
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State | NY
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Zip | 11418
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Country | US
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Telephone | 718-657-7093
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Fax | 718-558-5314
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Provider Business Mailing Address
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Address Line | 80 MARCUS DR PROVIDER ENROLLMENT
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City | MELVILLE
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State | NY
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Zip | 11747-4230
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Country | US
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Telephone | 631-391-7887
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Fax | 631-454-4163
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 234152
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License Number State | NY
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