Doctor Name: | MR. ANTHONY JOHN PUCCIO |
NPI Number: | 1578647913 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. CCC-SLP |
License Number: | SL005655L |
Business Practice Address: | 104 N 16th St Lewisburg, PA - 178371228 |
Business Phone Number: | 5705246060 |
Business Fax Number: | 5705246061 |
Mailing Address: | 104 N 16th St, LEWISBURG |
State: | PA |
Postal Code: | 178371228 |
Phone Number: | 5705246060 |
Fax Number: | 5705246061 |
NPI Enumeration Date: | 10/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL005655L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |