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NPI Code Detail

MEDICARE: CAROL GULLA NP

MEDICARE: CAROL GULLA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner26NN09719400NJ

General Provider Information

NPI Number : 1487646840
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL GULLA NP
Provider Business Mailing Address
First Line : 27 POPLAR ST
Second Line :
City : CEDAR RUN
State : NJ
Zip : 08092-2837
Country : US
Telephone Number : 609-978-1597
Fax Number :
Provider Business Practice Location Address
First Line : 640 WHITE HORSE PIKE
Second Line :
City : HAMMONTON
State : NJ
Zip : 08037-9602
Country : US
Telephone Number : 609-567-9003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2005
Last Update Date : 07/08/2007

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