Healthcare Provider Details

I. General information

NPI: 1942595251
Provider Name (Legal Business Name): STEPHANIE PULEO PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 GREAT NECK RD
GREAT NECK NY
11021-3305
US

IV. Provider business mailing address

15812 97TH ST
HOWARD BEACH NY
11414-3227
US

V. Phone/Fax

Practice location:
  • Phone: 516-466-3050
  • Fax:
Mailing address:
  • Phone: 848-702-0712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number056474
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0011629
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: