Individual provider Active NPI

Lisa Christine Pulkoski, LMSW

  • Social Worker
  • Little Neck, NY
National Provider Identifier
1689318438
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
109077 Issued in NY
Practice address
4177 Little Neck Pkwy
Little Neck, NY 11363-1738
Phone
(718) 423-8491
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 109077 NY Primary

Addresses

Primary practice location

4177 Little Neck Pkwy
Little Neck, NY 11363-1738

Mailing address

234 Beach 119TH St
Rockaway Park, NY 11694-1977
Phone (917) 470-4418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
109077NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1689318438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 BEACH 119TH ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116941977",
            "telephone_number": "917-470-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4177 LITTLE NECK PKWY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113631738",
            "telephone_number": "718-423-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULKOSKI",
        "first_name": "LISA",
        "middle_name": "CHRISTINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

Verify at the official NPI Registry.