MEDICARE: DR. SUNEEL KOUL 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	207R00000X	Internal Medicine Physician	208275	NY
2	207P00000X	Emergency Medicine Physician	208275	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881601276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUNEEL KOUL MD

Provider Business Mailing Address
First Line	:	2116 E HENRIETTA RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4518
Country	:	US
Telephone Number	:	585-204-0551
Fax Number	:

Provider Business Practice Location Address
First Line	:	2116 E HENRIETTA RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4518
Country	:	US
Telephone Number	:	585-204-0551
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	03/20/2023

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