Provider Demographics
NPI:1184701674
Name:SAULLE, NUNZIO (MD)
Entity type:Individual
Prefix:DR
First Name:NUNZIO
Middle Name:
Last Name:SAULLE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-7005
Mailing Address - Country:US
Mailing Address - Phone:718-940-8100
Mailing Address - Fax:
Practice Address - Street 1:1178 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-7005
Practice Address - Country:US
Practice Address - Phone:718-940-8100
Practice Address - Fax:718-940-8211
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187572208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01635092Medicaid
NY93E482Medicare ID - Type Unspecified
NY01635092Medicaid