Basic Information
Provider Information
NPI: 1831254655
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TULIN
FirstName: STEVEN
MiddleName: JAY
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2041 GEORGIA AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200600001
CountryCode: US
TelephoneNumber: 2028656679
FaxNumber: 2028653138
Practice Location
Address1: 2 WRAMC RM 2J38
Address2: 6900 GEORGIA AVE NW
City: WASHINGTON
State: DC
PostalCode: 203070001
CountryCode: US
TelephoneNumber: 2027825520
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/22/2006
LastUpdateDate: 12/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X02758MDN Behavioral Health & Social Service ProvidersPsychologist 
103T00000X DCY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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