Provider Demographics
NPI:1811943210
Name:ULSTER FAMILY MEDICINE, LLP
Entity type:Organization
Organization Name:ULSTER FAMILY MEDICINE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-338-3737
Mailing Address - Street 1:35 BARBAROSSA LN
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-1221
Mailing Address - Country:US
Mailing Address - Phone:845-338-3737
Mailing Address - Fax:845-338-3939
Practice Address - Street 1:35 BARBAROSSA LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1221
Practice Address - Country:US
Practice Address - Phone:845-338-3737
Practice Address - Fax:845-338-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8577OtherCDPHP GROUP NUMBER
NY73660OtherMVP GROUP NUMBER
NY02066264Medicaid
NYW34802Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER