Individual
PEACE KULLERKUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PARAMEDIC
Contact information
Practice address
152 BANKO DR, DEPEW, NY 14043-1206
(716) 240-8523
Mailing address
152 BANKO DR, DEPEW, NY 14043-1206
(716) 240-8523
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
129508
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74-3156453
FEDERAL NUMBER
NY
Enumeration date
03/13/2018
Last updated
03/13/2018
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