Individual
JOSEPH PUCCINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7545 N PORT WASHINGTON RD, GLENDALE, WI 53217-3422
(414) 351-3500
(414) 351-9063
Mailing address
7545 N PORT WASHINGTON RD, GLENDALE, WI 53217-3422
(414) 351-3500
(414) 351-9063
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
33107
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31804900
—
WI
Enumeration date
06/27/2005
Last updated
11/16/2022
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