Individual
MS. MARIE BOOKER MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6500
(212) 241-8456
(212) 426-5107
Mailing address
779 CONCOURSE VLG E, APT. 1D, BRONX, NY 10451-3705
(212) 241-8456
(212) 426-5107
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400350
NY
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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