Provider Demographics
NPI:1982813796
Name:METULA, AMY BRULL (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BRULL
Last Name:METULA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:25 PLAZA ST W APT 4D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3946
Mailing Address - Country:US
Mailing Address - Phone:347-689-4288
Mailing Address - Fax:212-731-5545
Practice Address - Street 1:25 PLAZA ST W APT 4D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3946
Practice Address - Country:US
Practice Address - Phone:347-689-4288
Practice Address - Fax:212-731-5545
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY304107363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health