Provider Demographics
NPI:1992191969
Name:EBERLY PULEO, ASHLEIGH ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:ELIZABETH
Last Name:EBERLY PULEO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:ELIZABETH
Other - Last Name:EBERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:14 BAY DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-4182
Mailing Address - Country:US
Mailing Address - Phone:248-798-4896
Mailing Address - Fax:
Practice Address - Street 1:450 BROOKLINE AVE
Practice Address - Street 2:YAWKEY BUILDING, FLOOR 11
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-632-6571
Practice Address - Fax:617-632-6727
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00800363A00000X
MAPA5522363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant