Provider Demographics
NPI:1689784233
Name:PULLIAM, BARBARA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:PULLIAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-2021
Mailing Address - Country:US
Mailing Address - Phone:973-509-7335
Mailing Address - Fax:973-509-7335
Practice Address - Street 1:81 IRVING PL
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2208
Practice Address - Country:US
Practice Address - Phone:212-777-8019
Practice Address - Fax:973-509-7335
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007394-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical