Provider Demographics
NPI:1568868503
Name:CULLEN, CIARAN EMMET (DC)
Entity Type:Individual
Prefix:
First Name:CIARAN
Middle Name:EMMET
Last Name:CULLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3505
Mailing Address - Country:US
Mailing Address - Phone:914-345-6700
Mailing Address - Fax:914-345-6025
Practice Address - Street 1:64 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3505
Practice Address - Country:US
Practice Address - Phone:914-345-6700
Practice Address - Fax:914-345-6025
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor