Fullerton, Albert L

Fullerton, Albert L is an sole proprietor health care provider with primary practice located at 604 Main St , Woburn MA 01801-2982. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Fullerton, Albert L can be contacted via phone (781) 935-3710.

Contact Information

Primary practice address
604 Main St Woburn MA 01801-2982
Phone: (781) 935-3710
Fax: (781) 935-3410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 37514 Massachusetts

Profile Details

NPI number 1205822905
LBN Legal business name Fullerton, Albert L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2005
Last updated Jul 13th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205822905 NPPES
Massachusetts Other 11117 HPIP
Massachusetts MEDICAID 0172375 HPIP
Massachusetts Other 701381 HPIP

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