Individual
NICOLE BIFULCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-7893
Mailing address
15839 81ST ST, HOWARD BEACH, NY 11414-2920
(917) 578-7105
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/30/2015
Last updated
08/09/2022
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