Provider Demographics
NPI:1689756066
Name:ULMER, PAULA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:MARIE
Last Name:ULMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:176 GREENWICH AVE
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2026
Mailing Address - Country:US
Mailing Address - Phone:845-294-8914
Mailing Address - Fax:845-294-6874
Practice Address - Street 1:176 GREENWICH AVE
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2026
Practice Address - Country:US
Practice Address - Phone:845-294-8914
Practice Address - Fax:845-294-6874
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3682152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300020552Medicare PIN