# FULTON MEDICAL, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1841635133
- **Authorized official:** GRIGORIY KRICHMAR D.O. (OWNER)
- **Authorized official phone:** (631) 271-9151

## Contact information

- **Practice address:** 200 BOUNDARY AVE, STE. 200, MASSAPEQUA, NY 11758-1152
- **Practice address phone:** (631) 271-9151
- **Mailing address:** 200 BOUNDARY AVE, STE. 200, MASSAPEQUA, NY 11758-1152
- **Mailing address phone:** (631) 271-9151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 234331 | NY | Yes |

## Other

- **Enumeration date:** 05/01/2013
- **Last updated:** 05/01/2013