Provider Demographics
NPI:1992860936
Name:PUSTELAK, URSZULA BARBARA (MD)
Entity Type:Individual
Prefix:MRS
First Name:URSZULA
Middle Name:BARBARA
Last Name:PUSTELAK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:223 CALYER STREET
Mailing Address - Street 2:URSZULA PUSTELAK M.D.
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2730
Mailing Address - Country:US
Mailing Address - Phone:718-349-6434
Mailing Address - Fax:718-349-6434
Practice Address - Street 1:223 CALYER STREET
Practice Address - Street 2:URSZULA PUSTELAK M.D.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2730
Practice Address - Country:US
Practice Address - Phone:718-349-6434
Practice Address - Fax:718-349-6434
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY206187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01775231Medicaid
G55649Medicare UPIN
NY71Y851Medicare UPIN
NYG55649Medicare Oscar/Certification