Provider Demographics
NPI:1245427483
Name:CULLEN, WILLIAM H (PA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:CULLEN
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Gender:M
Credentials:PA
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Mailing Address - Street 1:114 WOODLAND ST
Mailing Address - Street 2:DEPARTMENT OF SURGERY
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1208
Mailing Address - Country:US
Mailing Address - Phone:860-714-4694
Mailing Address - Fax:860-714-8096
Practice Address - Street 1:114 WOODLAND ST
Practice Address - Street 2:DEPARTMENT OF SURGERY
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1208
Practice Address - Country:US
Practice Address - Phone:860-714-4694
Practice Address - Fax:860-714-8096
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2021-10-21
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1964OtherLICENSE