Provider Demographics
NPI:1548750797
Name:LOVE, HUGH TULLOS JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:TULLOS
Last Name:LOVE
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W 162ND ST APT A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-8142
Mailing Address - Country:US
Mailing Address - Phone:404-667-8401
Mailing Address - Fax:
Practice Address - Street 1:421 W 162ND ST APT A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-8142
Practice Address - Country:US
Practice Address - Phone:404-667-8401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021720103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist