Provider Demographics
NPI:1194949941
Name:PULIJAAL, VENKAT R (PHD)
Entity type:Individual
Prefix:DR
First Name:VENKAT
Middle Name:R
Last Name:PULIJAAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:BELLEVUE HOSPITAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-263-6454
Mailing Address - Fax:212-263-7930
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:BELLEVUE HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-263-6454
Practice Address - Fax:212-263-7930
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCOQ 31358247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician