Concepcion Alejandra Bulo, MS, RD, CDN, CLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

009023 Issued in NY

Practice address

3611 21St St
Long Island City, NY 11106-4705

Phone

(718) 482-7772

Fax

(718) 482-9648

NPI assigned

Jul 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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

• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855
  Medicare reassignment NPD
• Casa Bulo Nutrition

  • Registered Dietitian
  • Astoria, NY
  • NPI 1598355612

  Dietitian, Registered

  NPD Authorized official
• Bronxcare Health System

  • Clinical Social Worker
  • Bronx, NY
  • NPI 1326115692

  Dietitian, Registered

  NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1518489822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "212-545-2439",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 21ST ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064705",
            "telephone_number": "718-482-7772",
            "fax_number": "718-482-9648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "199 Mount Eden Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577703",
            "country_code": "US",
            "telephone_number": "718-992-7669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULO",
        "first_name": "CONCEPCION",
        "middle_name": "ALEJANDRA",
        "credential": "MS, RD, CDN, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maura Buckley
• Hazel Rumbaua Buenavista, M.D.
• Haley Buggy, PA-C
• Milagros Bulatao
• Sirah Bulkan, M.D.
• Adetoun Olusola Burgos
• Dara Burke, M.S., OTR/L
• Lindsey Burton-Thomas
• Raychelle Burwell, M.ED
• Allison Bussing, RN

• Registered Dietitian in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.