Healthcare Provider Details

I. General information

NPI: 1417994724
Provider Name (Legal Business Name): ALINA O. DULU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST
BRONX NY
10467-2401
US

IV. Provider business mailing address

63 LEE AVE
SCARSDALE NY
10583-5212
US

V. Phone/Fax

Practice location:
  • Phone: 212-774-1873
  • Fax:
Mailing address:
  • Phone: 646-288-9922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number243901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: