| Doctor Name: | MICHAEL PEZZULLO |
| NPI Number: | 1245582840 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SLP CCC |
| License Number: | 020537 |
| Business Practice Address: | Usa Meddac Bavaria Cmr 411, Bldg 700, Rose Barracks Apo, AE - 09112 |
| Business Phone Number: | 499662834719 |
| Business Fax Number: | 499662834721 |
| Mailing Address: | 134 Entrance Way, MAHOPAC |
| State: | NY |
| Postal Code: | 105411315 |
| Phone Number: | 8456286215 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2012 |
| NPI Last Update Date: | 10/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 020537 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |