NPIMap

Organization Active NPI

Goldklank & Fulmer Psychological Services PC

  • Psychologist
  • New York, NY
National Provider Identifier
1083984090
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4895 Issued in NY
Legal business name
GOLDKLANK & FULMER PSYCHOLOGICAL SERVICES PC
Practice address
740 W End Ave
New York, NY 10025-6246
Phone
(212) 222-7084
NPI assigned
Jan 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Authorized official

Name
Dr. Richard H. Fulmer, PH.D.
Title
Secretary
Phone
(212) 222-7084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 4895 NY Primary

Addresses

Primary practice location

740 W End Ave
New York, NY 10025-6246

Mailing address

740 W End Ave
New York, NY 10025-6246
Phone (212) 222-7084

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1083984090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256246",
            "telephone_number": "212-222-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256246",
            "telephone_number": "212-222-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDKLANK & FULMER PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "FULMER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "212-222-7084",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "4895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.