Provider Demographics
NPI:1316307838
Name:PULLIAN, NEWTON
Entity type:Individual
Prefix:
First Name:NEWTON
Middle Name:
Last Name:PULLIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37233 PANTON TER APT 1026
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-1933
Mailing Address - Country:US
Mailing Address - Phone:215-913-5075
Mailing Address - Fax:
Practice Address - Street 1:37233 PANTON TER APT 1026
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-1933
Practice Address - Country:US
Practice Address - Phone:215-913-5075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator