Provider Demographics
NPI:1821155243
Name:PETER J. PULEO, D.C., P.C.
Entity Type:Organization
Organization Name:PETER J. PULEO, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDANT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:PULEO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-781-4811
Mailing Address - Street 1:93 LIGHTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4305
Mailing Address - Country:US
Mailing Address - Phone:516-781-4811
Mailing Address - Fax:516-781-0859
Practice Address - Street 1:2566 NELSON DR
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-3615
Practice Address - Country:US
Practice Address - Phone:516-781-4811
Practice Address - Fax:516-781-0359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007036-3111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty