Individual provider Active NPI

Dorotht Ortiz Tulla, M.D.

  • Psychiatry Physician
  • Staten Island, NY
National Provider Identifier
1790825099
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
221935 Issued in NY
Practice address
29 Brielle Ave
Staten Island, NY 10314-6423
Phone
(718) 983-9570
Fax
(718) 983-0348
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 221935 NY Primary

Addresses

Primary practice location

29 Brielle Ave
Staten Island, NY 10314-6423

Mailing address

PO Box 525
Staten Island, NY 10314-0525
Phone (718) 983-9570

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
221935NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790825099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 525",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103140525",
            "telephone_number": "718-983-9570",
            "fax_number": "718-983-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BRIELLE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146423",
            "telephone_number": "718-983-9570",
            "fax_number": "718-983-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ TULLA",
        "first_name": "DOROTHT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "221935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.