Provider Demographics
NPI:1144545773
Name:KULIK, TOBIAS BENJAMIN (MD)
Entity type:Individual
Prefix:
First Name:TOBIAS
Middle Name:BENJAMIN
Last Name:KULIK
Suffix:
Gender:M
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 UNIVERSITY OF NEW MEXICO DEPT OF NEUROLOGY
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:228 SAINT CHARLES WAY STE 200
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4661
Practice Address - Country:US
Practice Address - Phone:717-851-5503
Practice Address - Fax:717-851-5507
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2016-07272084A2900X, 2084N0400X
MO20140049982084N0400X, 2084V0102X
PAFK49179182084N0400X
PAMD487368C2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology