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NPI Code Detail

MEDICARE: MELISSA ULLOA MA, LCAT, LP

MEDICARE:   MELISSA  ULLOA  MA, LCAT, LP
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
1101Y00000XCounselorP07324NY

General Provider Information

NPI Number : 1851815120
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ULLOA MA, LCAT, LP
Provider Business Mailing Address
First Line : 315 WYCKOFF AVE, 6TH FLOOR
Second Line :
City : BROOKLYN
State : NY
Zip : 11237-5842
Country : US
Telephone Number : 718-497-6090
Fax Number : 718-497-9495
Provider Business Practice Location Address
First Line : 315 WYCKOFF AVE, 6TH FLOOR
Second Line :
City : BROOKLYN
State : NY
Zip : 11237-5842
Country : US
Telephone Number : 718-497-6090
Fax Number : 718-497-9495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2017
Last Update Date : 07/21/2022

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