Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 014940 | NY |
N | 103G00000X | Clinical Psychologist | 014940 | NY |
N | 103TC0700X | Clinical Psychologist | 014940 | NY |
NPI | 1598826604 |
---|---|
Provider Name | Dr. Melissa Dawn Fulgieri |
First Address | North Bellmore, NY 11710-1533 |
Second Address | Bronx, NY 10461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |