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Organization
IMPERIAL MEDICAL, PC
Active
Organization
IMPERIAL MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELSA BULA PA (ADMINISTRATOR)
(917) 658-6470
Entity
Organization
Contact information
Practice address
3-9 SICKLES ST, SUITE 1A, NEW YORK, NY 10040-1642
(212) 304-0096
(212) 304-0037
Mailing address
3-9 SICKLES ST, SUITE 1A, NEW YORK, NY 10040-1642
(212) 304-0096
(212) 304-0037
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
201244
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01663872
—
NY
Enumeration date
04/01/2009
Last updated
06/04/2009
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