Individual
GLENESE A TULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 MORGAN CT, CENTRAL VALLEY, NY 10917-3524
(718) 629-7484
Mailing address
7 MORGAN CT, CENTRAL VALLEY, NY 10917-3524
(718) 629-7484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
341655
NY
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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