Provider Demographics
NPI:1164976890
Name:PULEIO, SCOTT (DPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PULEIO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 KOANI LOOP
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-3313
Mailing Address - Country:US
Mailing Address - Phone:808-727-9115
Mailing Address - Fax:
Practice Address - Street 1:53 KOANI LOOP
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-3313
Practice Address - Country:US
Practice Address - Phone:808-727-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-4206225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist