Healthcare Provider Details

I. General information

NPI: 1871409896
Provider Name (Legal Business Name): KRISTEN ULLMEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 NY-17M
GOSHEN NY
10924
US

IV. Provider business mailing address

8 SILO DR
WALDEN NY
12586-3411
US

V. Phone/Fax

Practice location:
  • Phone: 845-360-9323
  • Fax:
Mailing address:
  • Phone: 914-882-7817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: