Organization
FULTON FAMILY MEDICINE PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESTHER SERWADDA LUBINGA M.D. (OWNER)
(315) 532-8049
Entity
Organization
Contact information
Practice address
20 CANALVIEW MALL, FULTON, NY 13069-1735
(315) 532-8049
Mailing address
1782 STATE ROUTE 48, FULTON, NY 13069-4108
(315) 532-8049
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2618481
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03444819
—
NY
Enumeration date
02/09/2012
Last updated
05/01/2013
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