Provider Demographics
NPI:1558677716
Name:PULCHERI, MARA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARA
Middle Name:
Last Name:PULCHERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 PARK AVE
Mailing Address - Street 2:1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0385
Mailing Address - Country:US
Mailing Address - Phone:212-288-7193
Mailing Address - Fax:
Practice Address - Street 1:911 PARK AVE
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0385
Practice Address - Country:US
Practice Address - Phone:212-288-7193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine