MEDICARE: JANET L KULKA PA-C

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
1	363AM0700X	Medical Physician Assistant	MA052538	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00386523	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1508806399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET L KULKA PA-C

Provider Business Mailing Address
First Line	:	2808 OLD POST RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-3685
Country	:	US
Telephone Number	:	717-920-4400
Fax Number	:	717-920-4401

Provider Business Practice Location Address
First Line	:	2808 OLD POST RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-3685
Country	:	US
Telephone Number	:	717-920-4400
Fax Number	:	717-920-4401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	10/19/2007

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