Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 270593-1 | NY |
Y | 207VX0000X | Obstetrician | 270593-1 | NY |
NPI | 1114208725 |
---|---|
Provider Name | David Kulak |
First Address | Newark, NJ 07103-2757 |
Second Address | Newark, NJ 07103-2757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2011 |
Last Update Date | 03/07/2014 |