Individual provider · NPI-1
Christopher Michael Tully
Internal Medicine, Hematology · Mountain Lakes, NJ
NPI number1053585232
StatusActive
Last updated in NPPESFeb 11, 2025
Details
- NPI
- 1053585232
- Entity type
- Individual (NPI-1)
- Name
- Christopher Michael Tully
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2008
- Certification date
- Feb 11, 2025
- Last updated
- Feb 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RH0000X | Internal Medicine, Hematology | 25MA09479000 | NJ | Yes |
| 207RH0003X | Internal Medicine, Hematology & Oncology | 25MA09479000 | NJ | |
| 207RX0202X | Internal Medicine, Medical Oncology | 25MA09479000 | NJ |
Practice location
333 Route 46 WMountain Lakes, NJ 07046-1743
Phone 973-316-1701 · Fax 973-316-1708
Mailing address
333 Route 46 WMountain Lakes, NJ 07046-1743
Phone 973-316-1701
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