Provider Demographics
NPI:1760574586
Name:KHULPATEEA, TARULATA (MD)
Entity Type:Individual
Prefix:
First Name:TARULATA
Middle Name:
Last Name:KHULPATEEA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 PARKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1147
Mailing Address - Country:US
Mailing Address - Phone:516-599-6142
Mailing Address - Fax:
Practice Address - Street 1:4212 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5723
Practice Address - Country:US
Practice Address - Phone:516-513-1184
Practice Address - Fax:516-513-1187
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131615207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY84A841OtherBLUE CROSS
NYAP177OtherOXFORD
84A841Medicare PIN
NYB19581Medicare UPIN