Provider Demographics
NPI:1427332527
Name:YULI, CARMEN DEL ROSARIO (MS)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:DEL ROSARIO
Last Name:YULI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 NARROWS RD N APT 1209
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1546
Mailing Address - Country:US
Mailing Address - Phone:917-400-8644
Mailing Address - Fax:
Practice Address - Street 1:755 NARROWS RD N APT 1209
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1546
Practice Address - Country:US
Practice Address - Phone:917-400-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019544-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYKBJ009Y09199OtherBLUE CROSS & BLUE SHIELD