Provider Demographics
NPI:1306344718
Name:ULEND, DMITRY (NP)
Entity type:Individual
Prefix:
First Name:DMITRY
Middle Name:
Last Name:ULEND
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:DMYTRO
Other - Middle Name:
Other - Last Name:ULENDYEYEV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 W ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLENOLDEN
Mailing Address - State:PA
Mailing Address - Zip Code:19036-1101
Mailing Address - Country:US
Mailing Address - Phone:610-461-6522
Mailing Address - Fax:610-461-0142
Practice Address - Street 1:14200 BUSTLETON AVE STE 17
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1186
Practice Address - Country:US
Practice Address - Phone:267-934-6769
Practice Address - Fax:302-735-3845
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013108363L00000X
DELP-0000334363L00000X
PASP025446363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner