Provider Demographics
NPI:1699040261
Name:TULISANO, MELISSA ANN (DC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:TULISANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3316
Mailing Address - Country:US
Mailing Address - Phone:860-810-6440
Mailing Address - Fax:
Practice Address - Street 1:82-86 WOLCOTT HILL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-1252
Practice Address - Country:US
Practice Address - Phone:860-296-4446
Practice Address - Fax:860-296-0041
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC001907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor