Individual provider Active NPI

Nyantiok MW Bul

  • General Practice Registered Nurse
  • Syracuse, NY
National Provider Identifier
1215804679
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
746776 Issued in NY
Practice address
203 Berkshire Ave
Syracuse, NY 13208-3007
Phone
(315) 426-3600
Fax
(315) 426-3600
NPI assigned
Oct 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 746776 NY Primary

Addresses

Primary practice location

203 Berkshire Ave
Syracuse, NY 13208-3007

Mailing address

203 Berkshire Ave
Syracuse, NY 13208-3007
Phone (315) 426-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
746776NYMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1215804679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 BERKSHIRE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132083007",
            "telephone_number": "315-426-3600",
            "fax_number": "315-426-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 BERKSHIRE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132083007",
            "telephone_number": "315-426-3600",
            "fax_number": "315-426-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUL",
        "first_name": "NYANTIOK",
        "middle_name": "MW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "746776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.