Provider Demographics
NPI:1861522294
Name:PULERWITZ, LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:PULERWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MANNETTO COURT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6603
Mailing Address - Country:US
Mailing Address - Phone:631-367-4233
Mailing Address - Fax:631-367-4232
Practice Address - Street 1:4 MANNETTO COURT
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6603
Practice Address - Country:US
Practice Address - Phone:631-367-4233
Practice Address - Fax:631-367-4232
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085962207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY164221Medicare ID - Type Unspecified
NYB08860Medicare UPIN