DR. ANTONIO E PUENTE PHD
Clinical Neuropsychologist
Wilmington, North Carolina
Provider NPI: 1508968843
Provider Information:DR. ANTONIO E PUENTE PHD
Gender: M
Sole Proprietor
Practice Location:
1508 MILITARY CUTOFF ROAD STE 303 WILMINGTON, NC 28403 US
Tel: 910-509-9371 Fax: 910-509-9372
Business Mailing Address:
1508 MILITARY CUTOFF ROAD STE 303 WILMINGTON, NC 28403 US
Tel: 910-509-9371 Fax: 910-509-9372
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | NC | NC0831 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BCBS | 04461 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin