Provider Demographics
NPI:1326412776
Name:CHULEY, MICHAEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:CHULEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 VARICK ST
Mailing Address - Street 2:IHSC MEDICAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4811
Mailing Address - Country:US
Mailing Address - Phone:202-321-3369
Mailing Address - Fax:908-276-0363
Practice Address - Street 1:201 VARICK ST
Practice Address - Street 2:IHSC MEDICAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4811
Practice Address - Country:US
Practice Address - Phone:202-321-3369
Practice Address - Fax:908-276-0363
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY007672-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant