Individual
DR. NICOLE ULLRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, FEGAN 11, BOSTON, MA 02115-5724
(617) 355-6388
(617) 730-0284
Mailing address
300 LONGWOOD AVE, FEGAN 11, BOSTON, MA 02115-5724
(617) 355-6388
(617) 730-0284
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
219682
MA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
219682
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2078830
—
MA
Enumeration date
07/20/2006
Last updated
05/20/2013
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