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NPI Code Detail

MEDICARE: DR. SIRAH BULKAN M.D.

MEDICARE:  DR. SIRAH  BULKAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician230276NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770530412
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIRAH BULKAN M.D.
Provider Business Mailing Address
First Line : 3711 QUEENS BLVD
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-1725
Country : US
Telephone Number : 718-960-6205
Fax Number :
Provider Business Practice Location Address
First Line : 3711 QUEENS BLVD
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-1725
Country : US
Telephone Number : 718-960-6205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 07/31/2019

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Directions to “ DR. SIRAH BULKAN M.D.” Practice Location

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