Healthcare Provider Details

I. General information

NPI: 1437403433
Provider Name (Legal Business Name): LAUREN C PULINKA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 YOST BLVD COST COMMONS #5, STE 303
PITTSBURGH PA
15221-5283
US

IV. Provider business mailing address

641 MARYLAND AVE
PITTSBURGH PA
15232-1948
US

V. Phone/Fax

Practice location:
  • Phone: 412-816-0761
  • Fax:
Mailing address:
  • Phone: 412-439-4764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW129963
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: