Healthcare Provider Details

I. General information

NPI: 1013382803
Provider Name (Legal Business Name): CARYLEN DENISE HULCOOP R.N.,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2015
Last Update Date: 12/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 WALDEN AVE
CHEEKTOWAGA NY
14225-4914
US

IV. Provider business mailing address

1680 WALDEN AVE
CHEEKTOWAGA NY
14225-4914
US

V. Phone/Fax

Practice location:
  • Phone: 716-894-7777
  • Fax:
Mailing address:
  • Phone: 716-894-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number671627-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: