Laura Ashley Fuller-Polhamus, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5909 Issued in NJ

Practice address

134 W End Ave
Somerville, NJ 08876-1816

Phone

(908) 333-4646

NPI assigned

Dec 10, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1093044653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 W END AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088761816",
            "telephone_number": "908-333-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W END AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088761816",
            "telephone_number": "908-333-4646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Union St",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018401815",
            "country_code": "US",
            "telephone_number": "978-685-1337 x639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER-POLHAMUS",
        "first_name": "LAURA",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-10",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "5909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresenius Medical Care Somerville, LLC
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• Julie M Fuson, RDH
• April E Gadson
• Adam Galasso, DC
• Adelina Gallo, PHARMD

• Psychologist in Somerville, NJ
• Providers in Somerville, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.