Provider Demographics
NPI:1831356187
Name:VULLO, MARIA A (RDMS)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:A
Last Name:VULLO
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 BLEECKER ST
Mailing Address - Street 2:SUITE E-33
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2980
Mailing Address - Country:US
Mailing Address - Phone:917-519-3474
Mailing Address - Fax:
Practice Address - Street 1:4140 27TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3825
Practice Address - Country:US
Practice Address - Phone:917-519-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1190672471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography