Individual
MICHAEL J TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
210 BELLE MEAD RD, EAST SETAUKET, NY 11733-3522
(631) 689-1400
(631) 689-1595
Mailing address
210 BELLE MEAD RD, EAST SETAUKET, NY 11733-3522
(631) 689-1400
(631) 689-1595
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305746-1
NY
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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