Individual
LARISSA C CHIULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
(508) 941-0895
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
(508) 941-0895
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
269264
MA
208600000X
Surgery Physician
LP02244
RI
208600000X
Surgery Physician
MD15459
RI
Other
Enumeration date
05/20/2011
Last updated
05/28/2020
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