Provider Demographics
NPI:1023097391
Name:ULLMAN, LORI E (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:E
Last Name:ULLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:325 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8243
Practice Address - Country:US
Practice Address - Phone:716-630-1136
Practice Address - Fax:716-250-5913
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2016-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY216133-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161000580OtherEMPIRE PLAN
NY216133-9BOtherWORKER'S COMPENSATION
NY50128000068OtherFIDELIS
NY161000580OtherGHI
NY000525964002OtherHEALTH NOW
NY070017767OtherRR MEDICARE
NY161000580OtherNORTH AMERICAN PREFERRED
NY02049232Medicaid
NY0310949OtherIHA
NY00021015002OtherUNIVERA
NY161000580OtherNORTH AMERICAN PREFERRED
NYE01928Medicare UPIN