Individual
TAJI ALI MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 1ST AVE, NEW YORK, NY 10029-7491
(212) 423-6262
Mailing address
470 W 141ST ST APT 4A, NEW YORK, NY 10031-6208
(646) 596-6150
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
406347
NY
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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