Provider Demographics
NPI:1992098412
Name:PULCHNY, PAUL KENDALL (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:KENDALL
Last Name:PULCHNY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:640 S. STATE STREET
Mailing Address - Street 2:MAIL CODE 3055
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-480-1688
Mailing Address - Fax:302-480-9807
Practice Address - Street 1:630 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-1516
Practice Address - Country:US
Practice Address - Phone:302-684-8053
Practice Address - Fax:302-684-8059
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0010941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE200138225Medicaid