MEDICARE: RONALD S PULLI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	186661	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P010186661	OTHER	NY	BLUE CHOICE
2	9715327	OTHER	NY	GHI
3	MDH269	OTHER	NY	PREFERRED CARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	00524735005	OTHER	NM	COMMUNITY BLUE
6	5456538	OTHER	NY	AETNA
7	P02018661	OTHER	NY	BLUE SHIELD

General Provider Information

NPI Number	:	1689602864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD S PULLI MD

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVE
Second Line	:	BOX 629
City	:	ROCHESTER
State	:	NY
Zip	:	14642-0001
Country	:	US
Telephone Number	:	585-758-5700
Fax Number	:	585-758-1293

Provider Business Practice Location Address
First Line	:	2365 S CLINTON AVE
Second Line	:	SUITE 200
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2663
Country	:	US
Telephone Number	:	585-758-5700
Fax Number	:	585-758-1293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/06/2023

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Directions to “ RONALD S PULLI MD” Practice Location

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