Provider Demographics
NPI:1750044392
Name:PUFULETE, CIPRIAN MIHAIL (CPED)
Entity Type:Individual
Prefix:MR
First Name:CIPRIAN
Middle Name:MIHAIL
Last Name:PUFULETE
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 AMARILLO LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-3018
Mailing Address - Country:US
Mailing Address - Phone:919-343-1982
Mailing Address - Fax:919-343-1937
Practice Address - Street 1:25 AMARILLO LN
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-3018
Practice Address - Country:US
Practice Address - Phone:919-343-1982
Practice Address - Fax:919-343-1937
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
C50032222Z00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier