MEDICARE: DANIEL J CULLIFORD MD PC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1942826102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL J CULLIFORD MD PC

Provider Business Mailing Address
First Line	:	184 KENT AVE APT B414
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-3195
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	184 KENT AVE APT B414
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-3195
Country	:	US
Telephone Number	:	917-572-3885
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	DANIEL CULLIFORD
Credential	:
Telephone Number	:	917-572-3885

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	08/14/2020

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