Individual provider Active NPI

Mariline Ulysse

  • Specialist
  • Fresh Meadows, NY
National Provider Identifier
1922553866
Registry record updated Aug 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
731376 Issued in NY
Practice address
15813 72ND Ave
Fresh Meadows, NY 11365-1140
Phone
(718) 380-7600
NPI assigned
Aug 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 731376 NY Primary

Addresses

Primary practice location

15813 72ND Ave
Fresh Meadows, NY 11365-1140

Mailing address

2065 Grand Concourse
310
Bronx, NY 10453-3847
Phone (646) 351-3582

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
731376NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1922553866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 GRAND CONCOURSE",
            "address_2": "310",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104533847",
            "telephone_number": "646-351-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15813 72ND AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651140",
            "telephone_number": "718-380-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULYSSE",
        "first_name": "MARILINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-21",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "731376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2016; 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.