Healthcare Provider Details

I. General information

NPI: 1669092250
Provider Name (Legal Business Name): AMY THERESA PULIKEYIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PLAINSBORO RD STE 360
PLAINSBORO NJ
08536-1915
US

IV. Provider business mailing address

5 PLAINSBORO RD STE 360
PLAINSBORO NJ
08536-1915
US

V. Phone/Fax

Practice location:
  • Phone: 609-750-0011
  • Fax: 609-750-0022
Mailing address:
  • Phone: 609-750-0011
  • Fax: 609-750-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA12681300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: