Individual
ALIFYA OULTACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 POLY PL, BROOKLYN, NY 11209-7104
(718) 836-6600
Mailing address
74 GATLING PL, APT 6F, BROOKLYN, NY 11209-6051
(718) 836-6360
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/20/2007
Last updated
07/08/2007
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