Provider Demographics
NPI:1669645255
Name:CULLUM, BARBARA ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN
Last Name:CULLUM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GATEHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-4527
Mailing Address - Country:US
Mailing Address - Phone:845-238-2191
Mailing Address - Fax:
Practice Address - Street 1:51-55 NORTH RT. 9W
Practice Address - Street 2:HELEN HAYES HOSPITAL
Practice Address - City:WEST HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10993
Practice Address - Country:US
Practice Address - Phone:845-786-4156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004611-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant