Healthcare Provider Details

I. General information

NPI: 1245345180
Provider Name (Legal Business Name): CARLA CULHANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/05/2023
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 SOUTH AVE STE 207
ROCHESTER NY
14620-2762
US

IV. Provider business mailing address

8340 BANDFORD WAY STE 1
RALEIGH NC
27615-2755
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-6775
  • Fax: 585-341-8310
Mailing address:
  • Phone: 315-359-2827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number304397
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number304397
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number302827
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: