Individual
MARK ULITSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5030
(215) 707-3494
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-5030
(215) 707-3494
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD055596L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015311430005
—
PA
Enumeration date
07/31/2006
Last updated
03/21/2017
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