Healthcare Provider Details

I. General information

NPI: 1649708371
Provider Name (Legal Business Name): MEAGHAN H. CIULLO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEAGHAN P. HURLEY FNP

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4823
US

IV. Provider business mailing address

120 E 34TH ST APT 7E
NEW YORK NY
10016-4625
US

V. Phone/Fax

Practice location:
  • Phone: 631-678-7163
  • Fax:
Mailing address:
  • Phone: 631-678-7163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF341491-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: