MEDICARE: GARY E PULZ PD, NCSP, LPC

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
1	101YP2500X	Professional Counselor	37PC00142900	NJ

General Provider Information

NPI Number	:	1932314168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY E PULZ PD, NCSP, LPC

Provider Business Mailing Address
First Line	:	PO BOX 1207
Second Line	:
City	:	BEACH HAVEN
State	:	NJ
Zip	:	08008-0031
Country	:	US
Telephone Number	:	609-290-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 ENGLESIDE AVE
Second Line	:
City	:	BEACH HAVEN
State	:	NJ
Zip	:	08008-1762
Country	:	US
Telephone Number	:	609-290-4040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	07/08/2007

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