Individual
DAVID J PEZZULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1 KETTLE POINT AVE, EAST PROVIDENCE, RI 02914-5375
(401) 884-1177
(401) 884-8697
Mailing address
2 DUDLEY ST, STE 200, PROVIDENCE, RI 02905-3236
(401) 330-1428
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
782
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26729
BLUE CROSS BLUE SHIELD
RI
Enumeration date
07/11/2006
Last updated
02/15/2019
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