Healthcare Provider Details

I. General information

NPI: 1144291345
Provider Name (Legal Business Name): VALERIE VULLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HOPKINS RD
WILLIAMSVILLE NY
14221-1729
US

IV. Provider business mailing address

850 HOPKINS RD
WILLIAMSVILLE NY
14221-1729
US

V. Phone/Fax

Practice location:
  • Phone: 716-688-0075
  • Fax:
Mailing address:
  • Phone: 716-688-0075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number195783-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: