Provider Demographics
NPI:1417243320
Name:PULCRANO, RICHARD F (BSRT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:F
Last Name:PULCRANO
Suffix:
Gender:M
Credentials:BSRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 ROLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-3634
Mailing Address - Country:US
Mailing Address - Phone:304-634-1630
Mailing Address - Fax:
Practice Address - Street 1:250 ROLAND PARK DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-3634
Practice Address - Country:US
Practice Address - Phone:304-634-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12662471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography