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General NPI Number Information
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NPI Number | 1255331526
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Entity Type | Individual
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Provider Name | JAMES M PRIBULA MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 29 HOSPITAL HILL RD SUITE 1600
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City | SHARON
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State | CT
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Zip | 06069-2095
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Country | US
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Telephone | 860-364-5585
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 789
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City | SHARON
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State | CT
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Zip | 06069-0789
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Country | US
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Telephone | 860-364-4471
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Fax | 860-364-4410
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 78208
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License Number State | MA
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