Provider Demographics
NPI:1114103348
Name:PULLEY, GREG JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:
Last Name:PULLEY
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MORRIS PL
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1512
Mailing Address - Country:US
Mailing Address - Phone:732-492-0677
Mailing Address - Fax:
Practice Address - Street 1:27 MORRIS PL
Practice Address - Street 2:
Practice Address - City:OCEANPORT
Practice Address - State:NJ
Practice Address - Zip Code:07757-1512
Practice Address - Country:US
Practice Address - Phone:732-492-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker