Provider Demographics
NPI:1437420619
Name:BULATHSINGHALA, PAUL MANOJ
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:MANOJ
Last Name:BULATHSINGHALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 POSSUM HILL ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0346
Mailing Address - Country:US
Mailing Address - Phone:808-276-2246
Mailing Address - Fax:
Practice Address - Street 1:3170 E SUNSET RD., SUITE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:808-276-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst