Active NPI
Judith Pullman, LCSW
- Clinical Social Worker
- Rockville Centre, NY
National Provider Identifier
1326118936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0371581
- Practice address
- 100 North Village Avenue
Suite 18
Rockville Centre, NY 11570 - Phone
- (516) 432-7553
- Fax
- (516) 431-4605
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R0371581 | NY | Primary |
Addresses
Primary practice location
100 North Village Avenue
Suite 18
Rockville Centre, NY 11570
Mailing address
560 West Broadway
Apt 4N
Long Beach, NY 11561
Phone (516) 431-4605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070314000628 | NY | Practitioner - Clinical Social Worker | 1658474481 | Practice locations: Long Beach, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0371581 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326118936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 WEST BROADWAY",
"address_2": "APT 4N",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "11561",
"telephone_number": "516-431-4605",
"fax_number": "516-437-4605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NORTH VILLAGE AVENUE",
"address_2": "SUITE 18",
"city": "ROCKVILLE CENTRE",
"state": "NY",
"postal_code": "11570",
"telephone_number": "516-432-7553",
"fax_number": "516-431-4605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULLMAN",
"first_name": "JUDITH",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0371581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville Centre, NY
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.