Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | B282 | NV |
NPI | 1598747644 |
---|---|
Provider Name | Dr. Paul Robert Pirruccello |
First Address | Reno, NV 89509-5309 |
Second Address | Reno, NV 89509-5309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T67324 | (02) | NV |