Provider Demographics
NPI:1518282078
Name:HULSE, STEPHEN JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:HULSE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 OVERLOOK LN S
Mailing Address - Street 2:UNIT S
Mailing Address - City:CHESTERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12817-4529
Mailing Address - Country:US
Mailing Address - Phone:518-494-4537
Mailing Address - Fax:
Practice Address - Street 1:578 AVIATION RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1814
Practice Address - Country:US
Practice Address - Phone:518-792-7583
Practice Address - Fax:518-792-7583
Is Sole Proprietor?:No
Enumeration Date:2010-03-28
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist