Individual
DR. STEVEN RAYMOND PEZZULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
982 TIOGUE AVE, COVENTRY, RI 02816-6167
(401) 821-6800
(401) 821-8513
Mailing address
982 TIOGUE AVE, COVENTRY, RI 02816-6167
(401) 821-6800
(401) 821-8513
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5845
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336385350
BLUE CROSS
—
05
—
7003151
—
RI
Enumeration date
12/22/2008
Last updated
10/04/2010
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