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Individual

DR. STEPHEN J CHIULLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2201 SAN PEDRO DR NE, BUILDING 1, SUITE 215, ALBUQUERQUE, NM 87110-4133
(505) 889-0426
(505) 883-7304
Mailing address
2201 SAN PEDRO DR NE, BUILDING 1, SUITE 215, ALBUQUERQUE, NM 87110-4133
(505) 889-0426
(505) 883-7304

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
500
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7395
LOVELACE HEALTH PLAN
NM
01
NM00NB60
BLUE CROSS
NM
Enumeration date
03/13/2007
Last updated
07/08/2007
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