Provider Demographics
NPI:1134298003
Name:ALBULAK, MEHMET KERIM (MD)
Entity Type:Individual
Prefix:
First Name:MEHMET
Middle Name:KERIM
Last Name:ALBULAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-2901
Mailing Address - Country:US
Mailing Address - Phone:914-217-0518
Mailing Address - Fax:
Practice Address - Street 1:30 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-4221
Practice Address - Country:US
Practice Address - Phone:914-217-0518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198323207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01887232Medicaid
NYG46398Medicare UPIN