Individual
EMMANUEL M KULLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
185 GLENWOOD AVE, EAST ORANGE, NJ 07017-2009
(973) 687-8356
Mailing address
185 GLENWOOD AVE, EAST ORANGE, NJ 07017-2009
(973) 687-8356
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
K92202257409922
NJ
347C00000X
Private Vehicle
K92202257409922
NJ
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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