Provider Demographics
NPI:1447332721
Name:ULLMAN, JOEL C (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:C
Last Name:ULLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2071 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3701
Mailing Address - Country:US
Mailing Address - Phone:914-833-1000
Mailing Address - Fax:914-833-4226
Practice Address - Street 1:2071 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3701
Practice Address - Country:US
Practice Address - Phone:914-833-1000
Practice Address - Fax:914-833-4226
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY92501207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJU02696910Medicare PIN
NYB80627Medicare UPIN
NY269691Medicare PIN