M Denise Tully, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9340 Issued in NY

Practice address

600 McClellan St
Schenectady, NY 12304-1009

Phone

(518) 347-5709

Fax

(518) 347-5716

NPI assigned

Mar 16, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1396879573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MCCLELLAN STREET",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12304",
            "telephone_number": "518-347-5709",
            "fax_number": "518-347-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MCCLELLAN ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041009",
            "telephone_number": "518-347-5709",
            "fax_number": "518-347-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "M",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "9340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.