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Individual

CHRISTOPHER PEZZULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
295 FOREST AVE, 2ND FLOOR, PORTLAND, ME 04101-2018
(207) 772-5437
(207) 879-1537
Mailing address
295 FOREST AVE, 2ND FLOOR, PORTLAND, ME 04101-2018
(207) 772-5437
(207) 879-1537

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1505
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
293660099
ME
Enumeration date
12/15/2005
Last updated
06/24/2016
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