Organization
ROBERT A DITULLIO, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DITULLIO M.D. (CEO)
(617) 471-5290
Entity
Organization
Contact information
Practice address
157 WASHINGTON ST, QUINCY, MA 02169-5514
(617) 471-5290
(617) 984-0626
Mailing address
157 WASHINGTON ST, QUINCY, MA 02169-5514
(617) 471-5290
(617) 984-0626
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25475
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0176001
—
MA
01
—
025475
TUFTS HEALTH CARE
MA
01
—
666270
CIGNA
MA
01
—
8151
HARVARD PILGRIM
MA
Enumeration date
06/20/2007
Last updated
08/22/2020
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