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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KENT BULLIS, MD

Active

DR. KENT BULLIS, MD is a Addiction Medicine healthcare provider located in ITHACA, New York. NPI 1710079736 is currently active in the NPPES registry. Verify at CMS.

Addiction Medicine · ITHACA, NY

Registration Details

NPI Number
1710079736
Provider Type
Individual
Gender
Male
NPI Issued
Sep 28, 2006 (19.833337098261 yrs)
Last Updated
Sep 26, 2013
License
1034097 (IN)

Practice Information

Address
110 HO PLZ
ITHACA, NY, 148533102
Browse NY providers · Browse ZIP 14853
Phone
6072555155
Primary Specialty
Addiction Medicine
207QA0000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.