Provider Demographics
NPI:1720544182
Name:HULING, DAWN ANNISSA
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ANNISSA
Last Name:HULING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E COLLOM ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-2319
Mailing Address - Country:US
Mailing Address - Phone:267-310-9366
Mailing Address - Fax:267-437-3198
Practice Address - Street 1:44 E COLLOM ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-2319
Practice Address - Country:US
Practice Address - Phone:267-310-9366
Practice Address - Fax:267-437-3198
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA645300246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy