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NPI Code Detail

MEDICARE: MRS. FABIENNE GAILLARD ULYSSE NP

MEDICARE: MRS. FABIENNE GAILLARD ULYSSE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerF303160-1NY

General Provider Information

NPI Number : 1558537100
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FABIENNE GAILLARD ULYSSE NP
Provider Business Mailing Address
First Line : 5718 SECOND AVENUE FLOOR 2
Second Line :
City : BROOKLYN
State : NY
Zip : 11220
Country : US
Telephone Number : 646-754-8504
Fax Number : 646-754-8501
Provider Business Practice Location Address
First Line : 4802 10TH AVE
Second Line : ADMINISTRATIVE BUILDING
City : BROOKLYN
State : NY
Zip : 11219-2916
Country : US
Telephone Number : 718-283-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2008
Last Update Date : 08/20/2020

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