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General NPI Number Information
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NPI Number | 1619040425
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Entity Type | Individual
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Provider Name | MATTHEW DAVID PULLANO PT
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 310 MILLS AVE STE 202
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City | GREENVILLE
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State | SC
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Zip | 29605-4063
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Country | US
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Telephone | 864-202-6259
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Fax | 864-509-6641
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Provider Business Mailing Address
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Address Line | 3125 E MAIN ST
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City | ENDWELL
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State | NY
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Zip | 13760-5958
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Country | US
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Telephone | 607-748-7369
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Fax | 607-748-4189
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 017307-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10183
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License Number State | SC
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