Provider Demographics
NPI:1912193855
Name:PRITULA, HALINA (MD)
Entity Type:Individual
Prefix:
First Name:HALINA
Middle Name:
Last Name:PRITULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HALYNA
Other - Middle Name:
Other - Last Name:STECHYSHYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:# L-3552
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-6453
Mailing Address - Country:US
Mailing Address - Phone:740-383-7927
Mailing Address - Fax:740-383-7942
Practice Address - Street 1:1050 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6416
Practice Address - Country:US
Practice Address - Phone:740-383-8047
Practice Address - Fax:740-375-8166
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0918312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2836695Medicaid
OH000000568962OtherANTHEM
OH000000568962OtherANTHEM
OH2836695Medicaid