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General NPI Number Information
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NPI Number | 1760012892
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Entity Type | Individual
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Provider Name | STEPHEN JAMES PULIAFICO PHD
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Gender | Male
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 103 E 86TH ST APT 1E
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City | NEW YORK
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State | NY
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Zip | 10028-1041
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Country | US
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Telephone | 413-758-1758
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Fax |
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Provider Business Mailing Address
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Address Line | 311 E 92ND ST APT 4W
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City | NEW YORK
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State | NY
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Zip | 10128-5455
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Country | US
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Telephone | 732-754-3691
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 023631
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License Number State | NY
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