ANTHONY DEMETRIUS FULLER

AMITYVILLE, NY
NPI1073636494
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  228275)
Enumeration Date2007-04-09
Last Update Date2007-07-08
Business Address
Mr. ANTHONY DEMETRIUS FULLER L.P.N
44 THE BLVD
AMITYVILLE, NY 11701-1433
Phone number: 631-608-8741
Mailing Address
Mr. ANTHONY DEMETRIUS FULLER L.P.N
44 THE BLVD
AMITYVILLE, NY 11701-1433
Phone number: 631-608-8741
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