Provider Demographics
NPI:1942632377
Name:ZULLO, FRED A (BS)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:A
Last Name:ZULLO
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 ARCH RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-3002
Mailing Address - Country:US
Mailing Address - Phone:603-543-8936
Mailing Address - Fax:
Practice Address - Street 1:37 ARCH RD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-3002
Practice Address - Country:US
Practice Address - Phone:603-543-8936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist