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General NPI Number Information
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NPI Number | 1306344718
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Entity Type | Individual
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Provider Name | DMITRY ULEND NP
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Gender | Male
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 14200 BUSTLETON AVE STE 17
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City | PHILADELPHIA
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State | PA
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Zip | 19116-1186
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Country | US
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Telephone | 267-934-6769
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Fax | 302-735-3845
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Provider Business Mailing Address
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Address Line | 901 W ASHLAND AVE
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City | GLENOLDEN
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State | PA
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Zip | 19036-1101
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Country | US
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Telephone | 610-461-6522
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Fax | 610-461-0142
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5013108
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LP-0000334
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP025446
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License Number State | PA
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