Provider Demographics
NPI:1720024482
Name:KULIN, JOHN CHARLES (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:KULIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 ROUTE 539
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-9770
Mailing Address - Country:US
Mailing Address - Phone:609-549-8344
Mailing Address - Fax:609-879-5484
Practice Address - Street 1:2605 SHORE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2136
Practice Address - Country:US
Practice Address - Phone:609-365-5333
Practice Address - Fax:609-365-5306
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB58599207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF95632Medicare UPIN
NJ580151UQBMedicare ID - Type UnspecifiedCMS PROVIDER ID #