Provider Demographics
NPI:1144401118
Name:GREGORY J KULEY AND ASSOC
Entity Type:Organization
Organization Name:GREGORY J KULEY AND ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:STOGSDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-351-8414
Mailing Address - Street 1:5945 RIDGE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-1659
Mailing Address - Country:US
Mailing Address - Phone:513-351-8414
Mailing Address - Fax:513-351-8414
Practice Address - Street 1:5945 RIDGE AVE STE 4
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1659
Practice Address - Country:US
Practice Address - Phone:513-351-8414
Practice Address - Fax:513-351-8414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3545/T749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0479898Medicaid
OH0479898Medicaid
OHT47482Medicare UPIN