Individual provider Active NPI

Josephine Ann Dulak, N.P.

  • Nurse Practitioner
  • Albany, NY
National Provider Identifier
1205864808
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
304312 Issued in NY
Practice address
25 Hackett Blvd
MC-141
Albany, NY 12208-3462
Phone
(518) 262-5550
NPI assigned
Jun 30, 2006
Last updated
Sep 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 304312 NY Primary

Addresses

Primary practice location

25 Hackett Blvd
MC-141
Albany, NY 12208-3462

Mailing address

25 Hackett Blvd
MC-141
Albany, NY 12208-3462
Phone (518) 262-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
304312NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1205864808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HACKETT BLVD",
            "address_2": "MC-141",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083462",
            "telephone_number": "518-262-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HACKETT BLVD",
            "address_2": "MC-141",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083462",
            "telephone_number": "518-262-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULAK",
        "first_name": "JOSEPHINE",
        "middle_name": "ANN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "304312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.