Individual
MS. KATHLEEN MARY BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 FARMINGDALE RD, WEST BABYLON, NY 11704-6545
(631) 669-5355
Mailing address
271 FOSTER AVE, SAYVILLE, NY 11782-3156
(631) 256-6992
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
388559
NY
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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