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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:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
NCNC0831

Other Provider Identifiers:

IssuerNumberStateType
BCBS0446101
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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