Provider Demographics
NPI:1518930148
Name:DRULLINSKY, ALEXIS C (MD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:C
Last Name:DRULLINSKY
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:PO BOX 95000-2454
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2454
Mailing Address - Country:US
Mailing Address - Phone:914-749-7000
Mailing Address - Fax:914-769-1824
Practice Address - Street 1:55 EAST 34TH STREET, 1ST FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-252-6131
Practice Address - Fax:212-252-6105
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202978207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01998296Medicaid
NY24N711Medicare ID - Type Unspecified
NY01998296Medicaid