Provider Demographics
NPI:1467822155
Name:ULRICH, STEPHANIE (DVM)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:ULRICH
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4549
Mailing Address - Country:US
Mailing Address - Phone:516-938-4106
Mailing Address - Fax:516-938-4830
Practice Address - Street 1:360 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4549
Practice Address - Country:US
Practice Address - Phone:516-938-4106
Practice Address - Fax:516-938-4830
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007446174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian