Healthcare Provider Details

I. General information

NPI: 1720626898
Provider Name (Legal Business Name): MARGARET HULL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 BROADWAY
SARANAC LAKE NY
12983-1146
US

IV. Provider business mailing address

PO BOX 1
PAUL SMITHS NY
12970-0001
US

V. Phone/Fax

Practice location:
  • Phone: 518-897-1000
  • Fax:
Mailing address:
  • Phone: 518-327-5016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number301658-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: