Individual provider · Type 1 NPI
Wanda Santos Ciulla, PHYSICIAN ASSISTANT
Medical Physician Assistant · Paris, IL
NPI number
1417460833
Active
Practice location
509 S Main St
Paris, IL 61944-2325
Mailing address
10027 Indian Boundary St
Paris, IL 61944-8253
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician | 208D00000X | 085000243 (NY) |
| Physician Assistant | 363A00000X | 085000243 (NY) |
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 085000243 (NY) |
| Medical Physician Assistant | 363AM0700X | 085000243 (IL) |
| Medical Physician Assistant Primary | 363AM0700X | 085000243 (NY) |
Medical Physician Assistant: Definition to come...
About NPI 1417460833
Wanda Santos Ciulla, PHYSICIAN ASSISTANT's National Provider Identifier is 1417460833, issued on Nov 7, 2017. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Paris, IL. The record was last updated on Nov 7, 2017.