Healthcare Provider Details

I. General information

NPI: 1932037165
Provider Name (Legal Business Name): IRINA NULMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 VICTORY BLVD
STATEN ISLAND NY
10301-3914
US

IV. Provider business mailing address

519 ODER AVE
STATEN ISLAND NY
10304-4407
US

V. Phone/Fax

Practice location:
  • Phone: 718-442-8351
  • Fax:
Mailing address:
  • Phone: 917-691-3551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF358880
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: