Healthcare Provider Details

I. General information

NPI: 1912211368
Provider Name (Legal Business Name): CHRISTINE HELENE HULL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CHESTERWOOD DR
SELKIRK NY
12158-1256
US

IV. Provider business mailing address

37 CHESTERWOOD DR
SELKIRK NY
12158-1256
US

V. Phone/Fax

Practice location:
  • Phone: 518-475-0132
  • Fax:
Mailing address:
  • Phone: 518-475-0132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number005468-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: