Individual
DR. TAMARA ANN PRULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(585) 247-6810
(315) 589-9406
Mailing address
3388 RIDGE RD, WILLIAMSON, NY 14589-9352
(315) 589-9657
(315) 589-9406
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
214246-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000527179003
BCBS
NY
05
—
02390949
—
NY
01
—
P00203836
RRM LEGACY
NY
01
—
P00393355
RAILROAD
NY
Enumeration date
06/20/2006
Last updated
01/09/2023
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