Individual
ANTHONY FULMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
36 HART ST, BROOKLYN, NY 11206-6402
(212) 470-7377
Mailing address
36 HART ST, BROOKLYN, NY 11206-6402
(212) 470-7377
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
347C00000X
NY
Other
Enumeration date
01/20/2020
Last updated
01/20/2020
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