Basic Information
| Provider Information | |||||||||
| NPI: | 1255580205 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PULMAN | ||||||||
| FirstName: | AUBRIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MOT, OTR/L | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VITIELLO | ||||||||
| OtherFirstName: | AUBRIE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MOT, OTR/L | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 232 SUNRISE AVE | ||||||||
| Address2: | |||||||||
| City: | HONESDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184311085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702518003 | ||||||||
| FaxNumber: | 5702518005 | ||||||||
| Practice Location | |||||||||
| Address1: | 232 SUNRISE AVE | ||||||||
| Address2: | |||||||||
| City: | HONESDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184311085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702518003 | ||||||||
| FaxNumber: | 5702518005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2008 | ||||||||
| LastUpdateDate: | 09/15/2008 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC009920 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.