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NPI Code Detail

MEDICARE: HEIDI LYNN PULLARA MS, OTRL

MEDICARE: HEIDI LYNN PULLARA MS, OTRL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist04750MD

General Provider Information

NPI Number : 1770605602
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI LYNN PULLARA MS, OTRL
Provider Business Mailing Address
First Line : 28 MANOR SPRINGS CT
Second Line :
City : GLEN ARM
State : MD
Zip : 21057-9500
Country : US
Telephone Number : 410-592-2572
Fax Number :
Provider Business Practice Location Address
First Line : 7700 YORK RD
Second Line :
City : TOWSON
State : MD
Zip : 21204-7513
Country : US
Telephone Number : 410-821-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 07/08/2007

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