Provider Demographics
NPI:1619636065
Name:ALAYNA PUCCINELLI DPM PC
Entity Type:Organization
Organization Name:ALAYNA PUCCINELLI DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ALAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUCCINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:858-294-4242
Mailing Address - Street 1:340 4TH AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3813
Mailing Address - Country:US
Mailing Address - Phone:858-294-4242
Mailing Address - Fax:858-294-3466
Practice Address - Street 1:340 4TH AVE STE 6
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3813
Practice Address - Country:US
Practice Address - Phone:858-294-4242
Practice Address - Fax:858-294-3466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty