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NPI Code Detail

MEDICARE: ELLEN MARIE CULLEN OTR/L

MEDICARE: ELLEN MARIE CULLEN OTR/L
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
1225XP0200XPediatric Occupational Therapist004837-1NY

General Provider Information

NPI Number : 1538454525
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN MARIE CULLEN OTR/L
Provider Business Mailing Address
First Line : 2034 LEHIGH STATION RD
Second Line :
City : HENRIETTA
State : NY
Zip : 14467-9616
Country : US
Telephone Number : 585-359-7925
Fax Number :
Provider Business Practice Location Address
First Line : 2034 LEHIGH STATION RD
Second Line :
City : HENRIETTA
State : NY
Zip : 14467-9616
Country : US
Telephone Number : 585-359-7925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2011
Last Update Date : 07/28/2024

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