Provider Demographics
NPI:1598038580
Name:MARIE PULINI MD PC
Entity Type:Organization
Organization Name:MARIE PULINI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PULINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-475-7109
Mailing Address - Street 1:60 GRAMERCY PARK N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5423
Mailing Address - Country:US
Mailing Address - Phone:212-475-7109
Mailing Address - Fax:212-475-2562
Practice Address - Street 1:60 GRAMERCY PARK N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5423
Practice Address - Country:US
Practice Address - Phone:212-475-7109
Practice Address - Fax:212-475-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113053261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB12785Medicare UPIN