Fulton, Paul Russell
Fulton, Paul Russell is an sole proprietor health care provider with primary practice located at 23 Pleasant St Suite 2, Newton Center MA 02459-1836. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Fulton, Paul Russell can be contacted via phone (617) 244-0131.Contact Information
Primary practice address
23 Pleasant St Suite 2
Newton Center MA 02459-1836
Phone: (617) 244-0131
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 4355 | Massachusetts |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 4355 | Massachusetts |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 4355 | Massachusetts |
Profile Details
| NPI number | 1558412296 |
|---|---|
| LBN Legal business name | Fulton, Paul Russell |
| Credentials | ED.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1558412296 | NPPES |
| Massachusetts | Other | WO4223 | BLUE CROSS PROVIDER ID |
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