Individual
ELLEN MARY MCNULTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
320 BEACH 104TH ST, ROCKAWAY PARK, NY 11694-2782
(718) 474-6918
(718) 945-8958
Mailing address
320 BEACH 104TH ST, ROCKAWAY PARK, NY 11694-2782
(718) 474-6918
(718) 945-8958
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
368986-1
NY
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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