Basic Information
| Provider Information | |||||||||
| NPI: | 1962889212 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ULFERS | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | KEMP | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4111 MOURNING DOVE DR | ||||||||
| Address2: | |||||||||
| City: | WATERLOO | ||||||||
| State: | IA | ||||||||
| PostalCode: | 507026107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3192400935 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 327 BEACH 19TH ST | ||||||||
| Address2: | |||||||||
| City: | FAR ROCKAWAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 116914423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188697815 | ||||||||
| FaxNumber: | 7188697834 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2015 | ||||||||
| LastUpdateDate: | 05/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 285506-01 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.