Healthcare Provider Details

I. General information

NPI: 1316980428
Provider Name (Legal Business Name): RICHARD I ULIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 PARK AVE
NEW YORK NY
10128-1154
US

IV. Provider business mailing address

1095 PARK AVE
NEW YORK NY
10128-1154
US

V. Phone/Fax

Practice location:
  • Phone: 212-860-0905
  • Fax: 212-410-1251
Mailing address:
  • Phone: 212-860-0905
  • Fax: 212-410-1251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number090806-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: