Mccullough, Gene P
Mccullough, Gene P is an individual health care provider with primary practice located at 1090 Amsterdam Ave St.Luke'S/Roosevelt Hospital Psychiatry Department, New York NY 10025-1737. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Mccullough, Gene P can be contacted via phone (917) 596-7336.Contact Information
Primary practice address
1090 Amsterdam Ave St.Luke'S/Roosevelt Hospital Psychiatry Department
New York NY 10025-1737
Phone: (917) 596-7336
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | F400071-1 | New York |
Profile Details
| NPI number | 1629068655 |
|---|---|
| LBN Legal business name | Mccullough, Gene P |
| Credentials | RN,NP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629068655 | NPPES |
| New York | MEDICAID | 02136450 |
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