Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 181045 | NY |
NPI | 1053360628 |
---|---|
Provider Name | Dr. Alan Bulbin |
First Address | Greenvale, NY 11548-1219 |
Second Address | Greenvale, NY 11548-1219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 08/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01445683 | (05) | NY |
112814003 | TAX ID (01) | |
F53184 | (02) | NY |