Individual
KAYLYN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 S COTTAGE ST APT 324, VALLEY STREAM, NY 11580-6359
(516) 761-0209
Mailing address
125 S COTTAGE ST APT 324, VALLEY STREAM, NY 11580-6359
(516) 761-0209
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
618813
NY
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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