Provider Demographics
NPI:1942658828
Name:HULL, ALEXANDER
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:HULL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 MAPLE ST STE C233A
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-4065
Mailing Address - Country:US
Mailing Address - Phone:978-304-8691
Mailing Address - Fax:978-304-8697
Practice Address - Street 1:480 MAPLE ST STE C233A
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-304-8391
Practice Address - Fax:978-304-8697
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2298367367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered