Individual
DR. JOHN P DETULLIO
Active
Individual
DR. JOHN P DETULLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.C.C.P.
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MA04345700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03F88
EMPIRE BCBS
NY
01
—
110098315
MEDICARE RAILROAD
NJ
05
—
1431005
—
NJ
01
—
223019073
TAX IDENTIFICATION NUMBER
NJ
01
—
223019073-002
QUALCARE
NJ
01
—
4093697
AETNA
NJ
01
—
41014
AETNA
NJ
01
—
F00797
HEALTH NET OF NJ
NJ
01
—
MS044
OXFORD
NJ
Enumeration date
08/18/2006
Last updated
11/04/2008
Update your record
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