Provider Demographics
NPI:1770503633
Name:KULAK, ROBERT G (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:KULAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:236 CRYSTAL RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4009
Mailing Address - Country:US
Mailing Address - Phone:845-692-3111
Mailing Address - Fax:845-692-0125
Practice Address - Street 1:236 CRYSTAL RUN ROAD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941
Practice Address - Country:US
Practice Address - Phone:845-692-3111
Practice Address - Fax:845-692-0125
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY109476208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery