Provider Demographics
NPI:1205170743
Name:PULA, ALEX J
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:J
Last Name:PULA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3539 KEANU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-7740
Mailing Address - Country:US
Mailing Address - Phone:808-225-0509
Mailing Address - Fax:
Practice Address - Street 1:3539 KEANU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-7740
Practice Address - Country:US
Practice Address - Phone:808-225-0509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant