| Doctor Name: | DR. CARMENCITA RAZO ULEP |
| NPI Number: | 1295921443 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 166052 |
| Business Practice Address: | 9245 Winchester Blvd Queens Village, NY - 114281871 |
| Business Phone Number: | 9175973418 |
| Business Fax Number: | 7184794567 |
| Mailing Address: | 9245 Winchester Blvd, QUEENS VILLAGE |
| State: | NY |
| Postal Code: | 114281871 |
| Phone Number: | 9175973418 |
| Fax Number: | 7184794567 |
| NPI Enumeration Date: | 09/21/2007 |
| NPI Last Update Date: | 09/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 166052 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |