Provider Demographics
NPI:1922005024
Name:PULIER, MYRON LEOPOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRON
Middle Name:LEOPOLD
Last Name:PULIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W END AVE
Mailing Address - Street 2:# 13E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5467
Mailing Address - Country:US
Mailing Address - Phone:212-787-9248
Mailing Address - Fax:954-867-1449
Practice Address - Street 1:800 W END AVE
Practice Address - Street 2:# 13E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5467
Practice Address - Country:US
Practice Address - Phone:212-787-9248
Practice Address - Fax:954-867-1449
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0967982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0827207Medicaid
NJPU460906Medicare ID - Type Unspecified
NJ0827207Medicaid