Provider Demographics
NPI:1053360628
Name:BULBIN, ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:BULBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2200 NORTHERN BLVD 205
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1219
Mailing Address - Country:US
Mailing Address - Phone:516-767-7771
Mailing Address - Fax:516-767-7765
Practice Address - Street 1:2200 NORTHERN BLVD 205
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1219
Practice Address - Country:US
Practice Address - Phone:516-767-7771
Practice Address - Fax:516-767-7765
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181045207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01445683Medicaid
112814003OtherTAX ID
NYF53184Medicare UPIN