Marie Booker McCullough, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F400350 Issued in NY

Practice address

1 Gustave L Levy PL
New York, NY 10029-6500

Phone

(212) 241-8456

Fax

(212) 426-5107

NPI assigned

May 23, 2008

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)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1679731814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 CONCOURSE VLG E",
            "address_2": "APT. 1D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513705",
            "telephone_number": "212-241-8456",
            "fax_number": "212-426-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-8456",
            "fax_number": "212-426-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "MARIE",
        "middle_name": "BOOKER",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliot Paradis McCullough, LMSW
• Gene P McCullough, RN,NP
• Hayley McCullough, DO
• Mackenzie McCullough
• Madison Zara McCullough, LCSW
• Stephen A McCullough, MD
• Taji Ali McCullough
• Kasi Rebecca McCune, M.D.
• Gilbert McCurdy, LCSW
• Henry Lloyd McCurtis, MD

• Psychiatric/Mental Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.