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Individual

MR. ROBIN H FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA C

Contact information

Practice address
37 W GARDEN ST, SUITE 105, AUBURN, NY 13021-2662
(315) 252-0000
(315) 252-0070
Mailing address
17 LANSING ST, AMMS, PC, AUBURN, NY 13021-1983
(315) 252-0000
(315) 252-0070

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
003118
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02903446
NY
Enumeration date
02/09/2007
Last updated
09/16/2016
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