Provider Demographics
NPI:1437295342
Name:DOCTORS PUN AND DELUCIA PC
Entity type:Organization
Organization Name:DOCTORS PUN AND DELUCIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:R
Authorized Official - Last Name:PUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-756-7788
Mailing Address - Street 1:134 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-756-7788
Mailing Address - Fax:203-754-1254
Practice Address - Street 1:134 GRANDVIEW AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-756-7788
Practice Address - Fax:203-754-1254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1241769Medicaid
CT100000154Medicare PIN
H36638Medicare UPIN
CTC00409Medicare PIN
B84044Medicare UPIN