Crystal Gayle Bullock

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

49D2314134 Issued in VA

Practice address

9838 Fairfax SQ Apt 264
Fairfax, VA 22031-4238

Phone

(917) 214-8795

NPI assigned

Mar 29, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1285437830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9838 FAIRFAX SQ APT 264",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314238",
            "telephone_number": "917-214-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9838 FAIRFAX SQ APT 264",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314238",
            "telephone_number": "917-214-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "CRYSTAL",
        "middle_name": "GAYLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "49D2314134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Budner & Associates O.D. P.a.
• Margaret Jean Buffardi
• Roberta Bugg-Bey
• Trang Phuong Bui
• Anna Bukont
• Kristin Bultman
• Meg Renee Bunker, LCSW
• Robert Allen Bunn, DDS
• Amanda Unalivia Buracker, PA-C
• Kathleen Joanne Buranych, N.P.

• Clinical Medical Laboratory in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.