Mark Anthony Logullo, D,C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1999210007 Issued in DE

Practice address

600 N Broad St
Suite 19
Middletown, DE 19709-1032

Phone

(302) 378-5441

Fax

(302) 378-3452

NPI assigned

Jan 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Logullo Chiropractic Wellness Center PA

  • Chiropractor
  • Middletown, DE
  • NPI 1588947790
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528110079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N BROAD ST",
            "address_2": "SUITE 19",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091032",
            "telephone_number": "302-378-5441",
            "fax_number": "302-378-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N BROAD ST",
            "address_2": "SUITE 19",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091032",
            "telephone_number": "302-378-5441",
            "fax_number": "302-378-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGULLO",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "D,C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "1999210007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Landon Levin, LCSW
• Lieske E2E Home Health Care Inc (Shorecare of Delaware)
• Jessica Denise Liguori
• Bradford Daniel Logue
• Logullo Chiropractic Wellness Center PA
• Alaina Lindsey Ryan Long, MA CCC-SLP
• Danna Loor Santos, PA-C
• Aisha Lord, MSPT DPT
• Erica Lynn Lorden
• Laura M Lundgren, M.D.

• Chiropractor in Middletown, DE
• Providers in Middletown, DE by specialty
• Chiropractor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.