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General NPI Number Information
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NPI Number | 1548558133
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Entity Type | Individual
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Provider Name | STEPHANIE PULIKKOTTIL JOSEPH M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 707 E MAIN ST
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2650
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Country | US
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Telephone | 845-333-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 10680 MEDLOCK BRIDGE RD STE 101
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City | JOHNS CREEK
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State | GA
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Zip | 30097-8420
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Country | US
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Telephone | 725-209-3053
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Fax | 855-927-7788
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 307576
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | A137779
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License Number State | CA
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