Provider Demographics
NPI:1730567538
Name:PAULSEN, JOHN DAVID JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:PAULSEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1468 MADISON AVENUE
Mailing Address - Street 2:ANNENBERG SUITE 15-38A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-4107
Mailing Address - Fax:
Practice Address - Street 1:1468 MADISON AVENUE
Practice Address - Street 2:ANNENBERG SUITE 15-38A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-4107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2020-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY296192207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology