Individual
J. RYAN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
909 THIRD AVE., SUITE 505 NEW YORK BEHAVIORAL HEALTH,, NEW YORK, NY 10022
(646) 495-3078
Mailing address
909 3RD AVE, SUITE 505, NEW YORK, NY 10022-4731
(646) 495-3078
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
017108
NY
Other
Enumeration date
04/24/2007
Last updated
08/20/2009
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