Provider Demographics
NPI:1043261258
Name:JOHN-HULL, CARLOTA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOTA
Middle Name:
Last Name:JOHN-HULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1903
Mailing Address - Country:US
Mailing Address - Phone:718-260-2995
Mailing Address - Fax:718-522-3186
Practice Address - Street 1:22 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1903
Practice Address - Country:US
Practice Address - Phone:718-260-2995
Practice Address - Fax:718-522-3186
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191350-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF62563Medicare UPIN
NY74H971Medicare ID - Type Unspecified