Fuller, Alisha M
Fuller, Alisha M is an individual health care provider with primary practice located at 390 Crystal Run Rd Suite 102, Middletown NY 10941. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fuller, Alisha M can be contacted via phone (845) 692-8780.Contact Information
Primary practice address
390 Crystal Run Rd Suite 102
Middletown NY 10941
Phone: (845) 692-8780
Fax: (845) 692-3439
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 333950 | New York |
Profile Details
| NPI number | 1083616544 |
|---|---|
| LBN Legal business name | Fuller, Alisha M |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2005 |
| Last updated | Oct 31st, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083616544 | NPPES |
| New York | MEDICAID | 02745279 |
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