Provider Demographics
NPI:1871099556
Name:PULLMAN, MARIEL YVONNE
Entity type:Individual
Prefix:DR
First Name:MARIEL
Middle Name:YVONNE
Last Name:PULLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 UNION SQUARE EAST
Mailing Address - Street 2:SUITE 5H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-844-8888
Mailing Address - Fax:212-844-8461
Practice Address - Street 1:10 UNION SQUARE EAST
Practice Address - Street 2:SUITE 5H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-844-8888
Practice Address - Fax:212-844-8461
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY3159512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program