Individual
PATRICIA STORK KILCULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
19 BRADHURST AVE, HAWTHORNE, NY 10532-2140
(914) 493-7000
Mailing address
4 STURDEVANT DR, DANBURY, CT 06811-3543
(203) 748-5754
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
002016
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
F302513-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004247814
—
CT
01
—
500001411
UNSPECIFIED
—
Enumeration date
05/24/2005
Last updated
10/16/2015
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