Basic Information
| Provider Information | |||||||||
| NPI: | 1720164759 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HULSE | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1515 WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | WALL TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077194906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325566449 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1944 STATE HIGHWAY 33 | ||||||||
| Address2: | JERSEY SHORE UNIVERSITY MEDICAL CENTER | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327764622 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 25MP00134000 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.