Most Relevant Information
Provider Data
NPI Number: | 1003463639 |
Provider Name: | ELIZABETH SUSAN PULLARA BSW |
Entity Type: | Individual |
Taxonomy Code: | 101Y00000X |
Specialty: | Counselor |
License Number: |
Most Important Dates
Enumeration Date: | 08/19/2019 |
Last Updated: | 08/19/2019 |
Provider Practice Location
161 E MAIN ST
SMITHTOWN
NY
117872879
Practice Location Phone/Fax
Phone: | 6313607578 |
Fax: |
Provider Mailing Location
161 E MAIN ST
SMITHTOWN
NY
117872879
Provider Mailing Phone/Fax
Phone: | 6313607578 |
Fax: |