Provider Demographics
NPI:1043046360
Name:KULBERG, ANTHONY (RN)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:KULBERG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 OCEAN PKWY APT 3G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7952
Mailing Address - Country:US
Mailing Address - Phone:347-866-9825
Mailing Address - Fax:
Practice Address - Street 1:2840 OCEAN PKWY APT 3G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7952
Practice Address - Country:US
Practice Address - Phone:347-866-9825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY736668163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse