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Individual

MR. BRIAN FULTON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.S.P.T.

Contact information

Practice address
2 DELAVERGNE AVE, C/O CENTER FOR PHYSICAL THERAPY, WAPPINGERS FALLS, NY 12590-1202
(845) 297-4789
(845) 297-8596
Mailing address
2 DELAVERGNE AVE, C/O CENTER FOR PHYSICAL THERAPY, WAPPINGERS FALLS, NY 12590-1202
(845) 297-4789
(845) 297-8596

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
026214
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000409356001
HEALTH NOW
01
100093
OPERATING ENGNRS LCL 825
01
10086264
CDPHP
01
2223675
CCN
01
2436962
UNITED HEALTH CARE
01
3575347
AETNA HMO
01
4126154
MVP
01
7998596
AETNA PPO
01
837295
MANAGED PHYSICAL NETWORK
01
P3308238
OXFORD
01
Q11J7
BLUE CROSS BLUE SHIELD
NY
Enumeration date
11/11/2005
Last updated
07/08/2007
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