Healthcare Provider Details

I. General information

NPI: 1063728962
Provider Name (Legal Business Name): SARAH KULP P.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE
NEW BRUNSWICK NJ
08901-1766
US

IV. Provider business mailing address

100 WITMER RD SUITE 220
HORSHAM PA
19044-2251
US

V. Phone/Fax

Practice location:
  • Phone: 732-745-8525
  • Fax:
Mailing address:
  • Phone: 215-442-5000
  • Fax: 215-957-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: