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NPI Code Detail

MEDICARE: DR. HILARY CERULLO DO

MEDICARE: DR. HILARY CERULLO DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianDO00624RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DO00624OTHERRISTATE OF RHODE ISLAND MEDICAL LICENSE

General Provider Information

NPI Number : 1467514182
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HILARY CERULLO DO
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 989 RESERVOIR AVE STE 101
Second Line :
City : CRANSTON
State : RI
Zip : 02910-5138
Country : US
Telephone Number : 401-572-3313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2006
Last Update Date : 08/29/2024

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Directions to “ DR. HILARY CERULLO DO” Practice Location

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