Provider Demographics
NPI:1588652838
Name:GULMI, FREDERICK ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ANTHONY
Last Name:GULMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6740 4TH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5350
Mailing Address - Country:US
Mailing Address - Phone:929-455-2700
Mailing Address - Fax:929-455-2770
Practice Address - Street 1:6740 4TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5350
Practice Address - Country:US
Practice Address - Phone:929-455-2700
Practice Address - Fax:929-455-2770
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152009208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01121333Medicaid
D91716Medicare UPIN
NY01121333Medicaid