Provider Demographics
NPI:1932481546
Name:FYFFE, ULLANDA (MD)
Entity Type:Individual
Prefix:
First Name:ULLANDA
Middle Name:
Last Name:FYFFE
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 1:721 CLIFTON AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1880
Mailing Address - Country:US
Mailing Address - Phone:973-777-7727
Mailing Address - Fax:973-779-7906
Practice Address - Street 1:721 CLIFTON AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1880
Practice Address - Country:US
Practice Address - Phone:973-777-7727
Practice Address - Fax:973-779-7906
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270011207Q00000X
NJ25MA09565400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine