MR. GENE P MCCULLOUGH (NPI# 1629068655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629068655 |
| Entity Type | Individual |
| Full Name | MR. GENE P MCCULLOUGH |
| Credential | RN,NP |
| Practice Address |
1090 Amsterdam Ave St.luke's/roosevelt Hospital Psychiatry Department New York NY 10025-1737 |
| Mailing Address |
129 Willoughby Ave Brooklyn NY 11205-3726 |
| Practice Telephone | 9175967336 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
F400071-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02136450 | 05 |
| Street Address |
1090 AMSTERDAM AVE ST.LUKE'S/ROOSEVELT HOSPITAL PSYCHIATRY DEPARTMENT |
| City | NEW YORK |
| State | NY |
| Zip Code | 10025-1737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164427522 | Gary R Burke | Internal Medicine | 1090 Amsterdam Ave, Fl 4, New York, NY 10025-1737 | 2005-06-14 |
| 1407490071 | Monique Shenise Titley | Social Worker | 1090 Amsterdam Ave, New York, NY 10025-1737 | 2019-11-06 |
| 1417428855 | Ewelina Wiecek | Social Worker | 1090 Amsterdam Ave, New York, NY 10025-1737 | 2018-12-11 |
| 1912432964 | Jeletta Jose | Student in an Organized Health Care Education/Training Program | 1090 Amsterdam Ave, New York, NY 10025-1737 | 2017-04-27 |
| 1710419437 | Sabrina Ghim | Student in an Organized Health Care Education/Training Program | 1090 Amsterdam Ave, Suite 16a, New York, NY 10025-1737 | 2017-03-31 |
| 1679005474 | Ziv Nir | Student in an Organized Health Care Education/Training Program | 1090 Amsterdam Ave, Suite F, 16th Floor, New York, NY 10025 | 2017-03-30 |
| 1538691860 | Vivian Chan | Student in an Organized Health Care Education/Training Program | 1090 Amsterdam Ave, Suite 16a, New York, NY 10025-1737 | 2017-03-27 |
| 1336670892 | Annesly Gates | Student in an Organized Health Care Education/Training Program | 1090 Amsterdam Ave, Suie 16a, New York, NY 10025-1737 | 2017-03-25 |
| 1023554318 | St.lukes Roosevelt Hospital Center Childrens Blended Case Managemen | Pediatrics | 1090 Amsterdam Ave, New York, NY 10025-1737 | 2017-01-11 |
| 1841748456 | Marianna Cordovano | Physician Assistant | 1090 Amsterdam Ave, Suite 10a, New York, NY 10025-1737 | 2016-09-13 |
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| 1528672870 | Alexandra E Lamm | Psychologist | 50 W 96th Street, Apt 5a-d, New York, NY 10025 | 2020-09-03 |
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| 1558910463 | Cherry Jones | Social Worker | 440 W 114th Street, Clark 6, New York, NY 10025 | 2019-09-04 |
| 1245894674 | Westside Nutrition Pllc | Dietitian, Registered | 240 West 102nd Street, Suite 15, New York, NY 10025 | 2019-05-01 |
| 1518429380 | Nathan Yehuda Ben Agi | Student in an Organized Health Care Education/Training Program | Mt. Sinai St. Lukes, 1111 Amsterdam Avenue, New York, NY 10025 | 2019-04-02 |
| 1366913196 | Mavis H Baird | Counselor | 243 W 99th St #3e, New York, NY 10025 | 2018-12-05 |
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| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
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| 1689227175 | Marianna Garibaldi | Nurse Practitioner | 246 W 38th St Fl 10, New York, NY 10018-5805 | 2019-07-23 |
| 1235781535 | Nathan Hanna | Nurse Practitioner | 6 E 39th St Ste 902, New York, NY 10016-0468 | 2019-07-16 |
| 1528610854 | Cohen Psychiatric Services Pllc | Nurse Practitioner | 57 W 57th St Ste 801, New York, NY 10019-2802 | 2019-07-16 |
| 1952962227 | Richard Callado | Nurse Practitioner | 245 5th Ave Ste 336, New York, NY 10016 | 2019-06-26 |
| 1467017392 | Shaneika Lindsay | Nurse Practitioner | 109 W 27th St Ste 5s, New York, NY 10001-6208 | 2019-05-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.