Provider Demographics
NPI:1174674238
Name:GULLI, MARIA TERESA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:TERESA
Last Name:GULLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHANNEL DR UNIT 1213
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07750-1340
Mailing Address - Country:US
Mailing Address - Phone:732-229-4933
Mailing Address - Fax:
Practice Address - Street 1:1 CHANNEL DR UNIT 1213
Practice Address - Street 2:
Practice Address - City:MONMOUTH BEACH
Practice Address - State:NJ
Practice Address - Zip Code:07750-1340
Practice Address - Country:US
Practice Address - Phone:732-229-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04869500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics