Healthcare Provider Details

I. General information

NPI: 1184654147
Provider Name (Legal Business Name): MAGDALEN ELEANOR HULL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 GRAND CONCOURSE
BRONX NY
10457-7606
US

IV. Provider business mailing address

7 KIVY ST
HUNTINGTON STATION NY
11746-2042
US

V. Phone/Fax

Practice location:
  • Phone: 718-992-7669
  • Fax:
Mailing address:
  • Phone: 631-385-8912
  • Fax: 631-385-0839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number142524
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: