Individual
DR. PAUL RUSSELL FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
23 PLEASANT ST, SUITE 2, NEWTON CENTER, MA 02459-1836
(617) 244-0131
Mailing address
35 PLEASANT ST, NEWTON CENTER, MA 02459-1812
(617) 244-0131
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
4355
MA
103TC0700X
Clinical Psychologist
4355
MA
103TF0200X
Forensic Psychologist
Primary
4355
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WO4223
BLUE CROSS PROVIDER ID
MA
Enumeration date
01/16/2007
Last updated
09/11/2025
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