Provider Demographics
NPI:1770253197
Name:TULIPAN, MOLLY (PSYD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:TULIPAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 E 33RD ST APT 8L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9475
Mailing Address - Country:US
Mailing Address - Phone:773-758-0116
Mailing Address - Fax:
Practice Address - Street 1:205 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6022
Practice Address - Country:US
Practice Address - Phone:212-335-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program