Provider Demographics
NPI:1730377805
Name:BRULE, GULNUR HARISOVNA (MD)
Entity type:Individual
Prefix:
First Name:GULNUR
Middle Name:HARISOVNA
Last Name:BRULE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2134
Mailing Address - Country:US
Mailing Address - Phone:508-910-3371
Mailing Address - Fax:508-910-3363
Practice Address - Street 1:225 FIELD ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2134
Practice Address - Country:US
Practice Address - Phone:508-910-3371
Practice Address - Fax:508-910-3363
Is Sole Proprietor?:No
Enumeration Date:2007-10-13
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics