Provider Demographics
NPI:1558627653
Name:CULOTTA, DEBBIE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:ANN
Last Name:CULOTTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 OSBORNE ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-5508
Mailing Address - Country:US
Mailing Address - Phone:718-227-9360
Mailing Address - Fax:
Practice Address - Street 1:54 OSBORNE ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-5508
Practice Address - Country:US
Practice Address - Phone:718-227-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400812-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool