Provider Demographics
NPI:1245345180
Name:CULHANE, CARLA
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:CULHANE
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 1:8340 BANDFORD WAY
Mailing Address - Street 2:STE 1
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2755
Mailing Address - Country:US
Mailing Address - Phone:315-359-2827
Mailing Address - Fax:
Practice Address - Street 1:990 SOUTH AVE STE 207
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2762
Practice Address - Country:US
Practice Address - Phone:585-341-6775
Practice Address - Fax:585-341-8310
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304397207RE0101X, 363LA2200X
NC302827363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02781762Medicaid