Provider Demographics
NPI:1942261300
Name:ULLUCCI, PAUL A JR (DPT, PHD, ATC, SCS)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:A
Last Name:ULLUCCI
Suffix:JR
Gender:M
Credentials:DPT, PHD, ATC, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 OLD SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02764-1824
Mailing Address - Country:US
Mailing Address - Phone:401-487-3582
Mailing Address - Fax:
Practice Address - Street 1:600 OLD SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:NORTH DIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02764-1866
Practice Address - Country:US
Practice Address - Phone:508-822-1135
Practice Address - Fax:508-822-4115
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI948225100000X, 2251S0007X
MA90202251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports