Individual
MS. ELLEN MACCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10225 67TH DR, APT. # 4L, FOREST HILLS, NY 11375-2860
(347) 886-7396
Mailing address
10225 67TH DR, APT. # 4L, FOREST HILLS, NY 11375-2860
(347) 886-7396
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
3331171
NY
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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