Doctor Name: | DENISE BULAK |
NPI Number: | 1396097358 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 521315 |
Business Practice Address: | 6000 Route 291 Marcy, NY - 13403 |
Business Phone Number: | 3152663200 |
Business Fax Number: | |
Mailing Address: | 67 Whitesboro St, YORKVILLE |
State: | NY |
Postal Code: | 134951313 |
Phone Number: | 3152663200 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2012 |
NPI Last Update Date: | 10/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 521315 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |