Doctor Name: | DR. RICHARD FULLER |
NPI Number: | 1699028175 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHARM.D |
License Number: | PI156802 |
Business Practice Address: | 3950 Union Rd Cheektowaga, NY - 142254252 |
Business Phone Number: | 7166343603 |
Business Fax Number: | |
Mailing Address: | 3950 Union Rd, CHEEKTOWAGA |
State: | NY |
Postal Code: | 142254252 |
Phone Number: | 7166343603 |
Fax Number: | |
NPI Enumeration Date: | 10/20/2012 |
NPI Last Update Date: | 02/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | PI156802 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |