Individual
MR. GENE P MCCULLOUGH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RN,NP
Contact information
Practice address
1090 AMSTERDAM AVE, ST.LUKE'S/ROOSEVELT HOSPITAL PSYCHIATRY DEPARTMENT, NEW YORK, NY 10025-1737
(917) 596-7336
Mailing address
129 WILLOUGHBY AVE, BROOKLYN, NY 11205-3726
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400071-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02136450
—
NY
Enumeration date
10/21/2005
Last updated
07/08/2007
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