Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 187762-1 | NY |
NPI | 1144215559 |
---|---|
Provider Name | Dr. Mona Pervil-Ulysse |
First Address | Brooklyn, NY 11215-2229 |
Second Address | Brooklyn, NY 11215-2229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 20/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01369906 | (05) | NY |
F34257 | (02) | NY |