Individual
ADAM DIPUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.C.C.-A.F.A.A.A.
Contact information
Practice address
5202 E. MAIN ST., SUITE #105, MESA, AZ 85205-8038
(480) 218-1328
(480) 218-1330
Mailing address
5202 E. MAIN ST., SUITE #105, MESA, AZ 85205-8038
(480) 218-1328
(480) 218-1330
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
DA2043
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396791141
INDIVIDUAL NPI
—
01
—
1881708261
GROUP NPI
—
05
—
894164
—
AZ
01
—
DA2043
STATE AUDIOLOGY LIC #
AZ
01
—
Y16021
GROUP UPIN
—
Enumeration date
05/25/2006
Last updated
08/27/2012
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