Provider Demographics
NPI:1255331526
Name:PRIBULA, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:PRIBULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-0789
Mailing Address - Country:US
Mailing Address - Phone:860-364-4471
Mailing Address - Fax:860-364-4410
Practice Address - Street 1:29 HOSPITAL HILL RD
Practice Address - Street 2:SUITE 1600
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2095
Practice Address - Country:US
Practice Address - Phone:860-364-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78208208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
043202198OtherHEALTH CARE VALUE MGMT
15567OtherHEALTH NEW ENGLAND
J30037OtherBC/BS OF MASSACHUSETTS
0030464OtherNEIGHBORHOOD HEALTH PLAN
043202198-015OtherCIGNA
J30037OtherHMO BLUE
043202198OtherFIRST HEALTH
78208OtherCONNECTICARE OF MA
000000008393OtherBOSTON MEDICAL CENTER HNP
043202198OtherCHILDRENS MED PLAN
043202198OtherGREAT WEST HEALTH PLAN
043202198OtherCBA
043202198OtherHMC - PPO
MA3112942Medicaid
043202198OtherBEECH STREET
043202198OtherCONSOLIDATED HEALTH PLAN
043202198OtherMULTI-PLAN
18252OtherHARVARD PILGRIM
B70803Medicare UPIN
MA3112942Medicaid