Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 036.120207 | IL |
NPI | 1023284536 |
---|---|
Provider Name | Dr. Olga Ulitsky |
First Address | Venice, FL 34285-4108 |
Second Address | Venice, FL 34285-4108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 09/03/2015 |