Provider Demographics
NPI:1205351772
Name:MUFFOLETTO, ISAAC
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:MUFFOLETTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SHAKER RD STE B007
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464-2585
Mailing Address - Country:US
Mailing Address - Phone:978-813-1120
Mailing Address - Fax:978-813-1126
Practice Address - Street 1:2 SHAKER RD STE B007
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:MA
Practice Address - Zip Code:01464
Practice Address - Country:US
Practice Address - Phone:978-813-1120
Practice Address - Fax:978-813-1126
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist