Provider Demographics
NPI:1154502581
Name:TY CULINER, PH.D. LLC
Entity Type:Organization
Organization Name:TY CULINER, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TY
Authorized Official - Middle Name:
Authorized Official - Last Name:CULINER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-862-6992
Mailing Address - Street 1:55 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-1340
Mailing Address - Country:US
Mailing Address - Phone:215-862-6992
Mailing Address - Fax:
Practice Address - Street 1:55 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-1340
Practice Address - Country:US
Practice Address - Phone:215-862-6992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008396L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0244068000OtherINDEPENDENCE BCBS
CU400592OtherHIGHMARKBCBS
PA072452Medicare PIN
PA072452Medicare UPIN