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General NPI Number Information
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NPI Number | 1023216264
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Entity Type | Organization
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Legal Business Name | BROOKLYN UROLOGIC HEALTH & ASSOCIATES
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 1 BROOKDALE PLZ SUITE: 5C4
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City | BROOKLYN
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State | NY
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Zip | 11212-3139
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Country | US
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Telephone | 718-240-5324
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Fax | 718-240-6605
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Provider Business Mailing Address
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Address Line | 1 BROOKDALE PLZ SUITE: 5C4
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City | BROOKLYN
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State | NY
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Zip | 11212-3139
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Country | US
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Telephone | 718-240-5324
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Fax | 718-240-6605
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FREDERICK GULMI
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Credential | M.D
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Telephone | 718-240-5324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 152009
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License Number State | NY
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