Provider Demographics
NPI:1609472208
Name:PULMANO, CONLEI
Entity Type:Individual
Prefix:
First Name:CONLEI
Middle Name:
Last Name:PULMANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 STATE ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1312
Mailing Address - Country:US
Mailing Address - Phone:732-422-4425
Mailing Address - Fax:732-422-4427
Practice Address - Street 1:3333 STATE ROUTE 27
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-1312
Practice Address - Country:US
Practice Address - Phone:732-422-4425
Practice Address - Fax:732-422-4427
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02880200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist