Most Relevant Information
Provider Data
| NPI Number: | 1003486622 |
| Provider Name: | ASIAJ C TULLON LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 341460 |
Most Important Dates
| Enumeration Date: | 06/26/2021 |
| Last Updated: | 06/26/2021 |
Provider Practice Location
2907 SIPP AVE
MEDFORD
NY
117631984
Practice Location Phone/Fax
| Phone: | 6314280666 |
| Fax: |
Provider Mailing Location
2907 SIPP AVE
MEDFORD
NY
117631984
Provider Mailing Phone/Fax
| Phone: | 6314280666 |
| Fax: |