Ivy Bullock

NPI #1023496718 in Wyandanch, New York

Provider Information

NPI Number: 1023496718
Entity Type: Individual
Name: Ivy Bullock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: May 13, 2015
Last Updated: Jun 15, 2022

Practice Location

Address: 240 LONG ISLAND AVE
City: Wyandanch
State: New York
ZIP Code: 11798-3123
Phone: (631) 782-6200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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