# FULTON FAMILY MEDICINE PRACTICE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275806036
- **Authorized official:** DR. ESTHER SERWADDA LUBINGA M.D. (OWNER)
- **Authorized official phone:** (315) 532-8049

## Contact information

- **Practice address:** 20 CANALVIEW MALL, FULTON, NY 13069-1735
- **Practice address phone:** (315) 532-8049
- **Mailing address:** 1782 STATE ROUTE 48, FULTON, NY 13069-4108
- **Mailing address phone:** (315) 532-8049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2618481 | NY | Yes |

## Other

- **Enumeration date:** 02/09/2012
- **Last updated:** 05/01/2013