Provider Demographics
NPI:1104591155
Name:PULEO, HEATHER (PA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PULEO
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:93 LIGHTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4305
Mailing Address - Country:US
Mailing Address - Phone:631-278-1846
Mailing Address - Fax:
Practice Address - Street 1:1300 FRANKLIN AVE STE UL3A
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1885
Practice Address - Country:US
Practice Address - Phone:516-747-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2022-03-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant