Melissa Sue Fuller

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

License

1740207299 Issued in NY

Practice address

133 Margaret St
Plattsburgh, NY 12901-2926

Phone

(518) 565-4868

Fax

(518) 565-4509

NPI assigned

Aug 10, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1477078459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 MARGARET ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012926",
            "telephone_number": "518-565-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MARGARET ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012926",
            "telephone_number": "518-565-4868",
            "fax_number": "518-565-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MELISSA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NY",
            "license": "1740207299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00583757",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela M. French, LMHC
• Ellen Frey-Comins, LMHC
• Richard B Frost, MD
• David W Frostick, PA
• Jun Fu, M.D.
• Kimberly Allyson Fulton, COTA
• Randy Furnia
• Elissa J Gadelha Pierotti, MD
• Stephen Galietta, CASAC
• Christina A Gallus, MD

• State or Local Public Health Clinic/Center in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• State or Local Public Health Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.