NPIMap

Organization Active NPI

Elizabeth Fulton

  • Substance Abuse Rehabilitation Facility
  • Bronx, NY
National Provider Identifier
1013126754
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
003121 Issued in NY
Legal business name
ELIZABETH FULTON
Practice address
1360 Clinton Ave
Apt. 2-D
Bronx, NY 10456-2535
Phone
(917) 405-8608
Fax
(718) 299-5905
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Elizabeth Fulton, BSNPI 1780378885
Title
Program Manager
Phone
(718) 299-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 003121 NY Primary

Addresses

Primary practice location

1360 Clinton Ave
Apt. 2-D
Bronx, NY 10456-2535

Mailing address

1360 Clinton Ave
Apt. 2-D
Bronx, NY 10456-2535
Phone (917) 405-8608

Other names 1

  • Palladia, Inc. Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013126754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 CLINTON AVE",
            "address_2": "APT. 2-D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104562535",
            "telephone_number": "917-405-8608",
            "fax_number": "718-299-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 CLINTON AVE",
            "address_2": "APT. 2-D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104562535",
            "telephone_number": "917-405-8608",
            "fax_number": "718-299-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH FULTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "718-299-3300",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "003121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palladia, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.