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Contact Information

ALISHA M FULLER, FNP
390 CRYSTAL RUN RD
SUITE 102
MIDDLETOWN, NY10941
 Phone: 845-692-8780
 Fax: 845-692-3439
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ALISHA M FULLER · (Female)

NPI # 1083616544
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 08/15/2005
Last updated 10/31/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 333950
  • NY Medicaid 02745279
Hospital affiliation(s)
  • ORANGE REGIONAL MEDICAL CENTER - (Acute Care)
    707 EAST MAIN STREET
    MIDDLETOWN, NY 10940
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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