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Organization

JACKLAB, INC

Active
Other names
John McNulty, M.D.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN F MCNULTY M.D. (PRESIDENT)
(845) 516-4836
Entity
Organization

Contact information

Practice address
6369 MILL ST, SUITE 201, RHINEBECK, NY 12572-1406
(845) 516-4836
(845) 516-4233
Mailing address
6369 MILL ST, SUITE 201, RHINEBECK, NY 12572-1406
(845) 516-4836
(845) 516-4233

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
206911
NY

Other

Enumeration date
09/08/2016
Last updated
09/08/2016
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