Provider Demographics
NPI:1265559199
Name:FULGER, ILMANA (MD)
Entity type:Individual
Prefix:DR
First Name:ILMANA
Middle Name:
Last Name:FULGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ILMANA
Other - Middle Name:
Other - Last Name:KORNBLUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:243 PARK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1436
Mailing Address - Country:US
Mailing Address - Phone:914-423-2029
Mailing Address - Fax:914-423-2029
Practice Address - Street 1:4487 3RD AVE
Practice Address - Street 2:FOURTH FLOOR CANCER CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1526
Practice Address - Country:US
Practice Address - Phone:718-960-6377
Practice Address - Fax:718-960-5522
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243615207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology