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NPI Code Detail

MEDICARE: ALAN DEAN ZULLI RN

MEDICARE:   ALAN DEAN ZULLI  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse474301-1NY

General Provider Information

NPI Number : 1982827291
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN DEAN ZULLI RN
Provider Business Mailing Address
First Line : 29 SIMEON RD
Second Line :
City : RIVERHEAD
State : NY
Zip : 11901-5414
Country : US
Telephone Number : 631-722-5229
Fax Number :
Provider Business Practice Location Address
First Line : EAST END CLINIC
Second Line : 300 CENTER DRIVE
City : RIVERHEAD
State : NY
Zip : 11901-0000
Country : US
Telephone Number : 631-852-2680
Fax Number : 631-852-2674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/08/2007

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