Individual
MS. CHARNELL GULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28 WALNUT RD, AMITYVILLE, NY 11701-1021
(631) 624-6539
Mailing address
28 WALNUT RD, AMITYVILLE, NY 11701-1021
(631) 624-6539
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326363
NY
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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