Provider Demographics
NPI:1013971795
Name:PRUNA, SIRONA GH (MD)
Entity Type:Individual
Prefix:
First Name:SIRONA
Middle Name:GH
Last Name:PRUNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SIRONA
Other - Middle Name:
Other - Last Name:PETEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWMARKET
Practice Address - State:NH
Practice Address - Zip Code:03857-1843
Practice Address - Country:US
Practice Address - Phone:603-659-3106
Practice Address - Fax:603-659-8003
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12945207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30205771Medicaid
NHI52326Medicare UPIN
RE8658Medicare PIN