Individual
MS. KRISTINA KULAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(215) 831-3050
(215) 831-3065
Mailing address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(215) 831-3050
(215) 831-3065
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC004562L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019365620002
—
PA
Enumeration date
11/15/2006
Last updated
07/09/2007
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