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General NPI Number Information
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NPI Number | 1023331709
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Entity Type | Individual
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Provider Name | DIANA CULLEN PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 100 INDEPENDENT WAY
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City | BREWSTER
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State | NY
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Zip | 10509-6301
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Country | US
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Telephone | 845-278-2700
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Fax | 845-279-7339
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Provider Business Mailing Address
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Address Line | 11 BACK CT
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City | STORMVILLE
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State | NY
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Zip | 12582-5404
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Country | US
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Telephone | 845-221-4993
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 033894
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License Number State | NY
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