Provider Demographics
NPI:1841505914
Name:BULBULIA, ABDULHAY AHMED (MD)
Entity type:Individual
Prefix:DR
First Name:ABDULHAY
Middle Name:AHMED
Last Name:BULBULIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5088 LAKE SHORE RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5753
Mailing Address - Country:US
Mailing Address - Phone:716-627-4060
Mailing Address - Fax:
Practice Address - Street 1:5088 LAKE SHORE RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-5753
Practice Address - Country:US
Practice Address - Phone:716-627-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111168207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine