Individual
MICHAEL LUIS PUELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 S CEDAR CREST BLVD FL 2, ALLENTOWN, PA 18103-6202
(610) 402-6164
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR23761800
NJ
367500000X
Certified Registered Nurse Anesthetist
26NJ15345300
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN771569
PA
Other
Enumeration date
04/26/2025
Last updated
07/22/2025
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