Provider Demographics
NPI:1073829578
Name:PULVER, PATRICIA ANNE (PA)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANNE
Last Name:PULVER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:NEW YORK STATE DEPARTMENT OF CORRECTIONS AND COMMUNITY
Mailing Address - Street 2:1220 WASHINGTON AVE, BUILDING 4
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12226-2050
Mailing Address - Country:US
Mailing Address - Phone:518-445-7565
Mailing Address - Fax:518-445-6157
Practice Address - Street 1:1220 WASHINGTON AVENUE
Practice Address - Street 2:BUILDING 4
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12226-2050
Practice Address - Country:US
Practice Address - Phone:518-457-8126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY002834-1363A00000X
NY002834363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant