Provider Demographics
NPI:1124649629
Name:BRASILEIRO SILVA PACHECO, TULIO (MD)
Entity type:Individual
Prefix:
First Name:TULIO
Middle Name:
Last Name:BRASILEIRO SILVA PACHECO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 RECTOR PL APT 32B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10280-1156
Mailing Address - Country:US
Mailing Address - Phone:917-244-4662
Mailing Address - Fax:
Practice Address - Street 1:222 STATION PLZ N STE 300
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3893
Practice Address - Country:US
Practice Address - Phone:516-663-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program