Provider Demographics
NPI:1427617935
Name:ULLMAN, CAITLIN A (PA)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:A
Last Name:ULLMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WESTMINSTER RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-6429
Mailing Address - Country:US
Mailing Address - Phone:315-534-4384
Mailing Address - Fax:
Practice Address - Street 1:20 WESTMINSTER RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-6429
Practice Address - Country:US
Practice Address - Phone:315-534-4384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant