Organization
ELIZABETH FULTON
Active
Other names
Palladia, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH FULTON BS (PROGRAM MANAGER)
(718) 299-3300
Entity
Organization
Contact information
Practice address
1360 CLINTON AVE, APT. 2-D, BRONX, NY 10456-2535
(917) 405-8608
(718) 299-5905
Mailing address
1360 CLINTON AVE, APT. 2-D, BRONX, NY 10456-2535
(917) 405-8608
(718) 299-5905
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
003121
NY
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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