Provider Demographics
NPI:1821295841
Name:ZULLO, EDWARD CARMEN (CA DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CARMEN
Last Name:ZULLO
Suffix:
Gender:M
Credentials:CA DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 S MAIN ST # 2
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1640
Mailing Address - Country:US
Mailing Address - Phone:609-439-8138
Mailing Address - Fax:
Practice Address - Street 1:1078 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977-1316
Practice Address - Country:US
Practice Address - Phone:609-439-8138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00024300171100000X
NJ38MC000438700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor