MR. ANTHONY DEMETRIUS FULLER (NPI# 1073636494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073636494 |
| Entity Type | Individual |
| Full Name | MR. ANTHONY DEMETRIUS FULLER |
| Credential | L.P.N |
| Practice Address |
44 The Blvd Amityville NY 11701-1433 |
| Practice Telephone | 6316088741 |
| Mailing Telephone | 6316088741 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 228275 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891823456 | Anthony Blair Fuller | Counselor | 3457 Kingston Pike, Knoxville, TN 37919-4633 | 2007-03-02 |
| 1073085999 | Anthony Raymond Fuller | Nurse Anesthetist, Certified Registered | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2018-12-18 |
| 1609184902 | Anthony Francis Fuller | Pharmacist | 982 5th St, Struthers, OH 44471-1527 | 2010-09-21 |
| Street Address |
44 THE BLVD |
| City | AMITYVILLE |
| State | NY |
| Zip Code | 11701-1433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013427400 | Katya Cabrera | Licensed Practical Nurse | 8 Coolidge Ave, North Amityville, NY 11701 | 2017-10-11 |
| 1750800405 | Laura M Sabatino-jan | Nurse Practitioner | 65 S. Emerson Avenue, Amity Harbor, NY 11701 | 2017-09-13 |
| 1104355536 | Massapequa Center LLC | Skilled Nursing Facility | 101 Louden Ave., Amityville, NY 11701 | 2017-06-08 |
| 1588193874 | Allison Herzog | Specialist | 41 Terry Avenue, Amityville, NY 11701 | 2017-06-08 |
| 1962949677 | Sherlin Golbari | Physician Assistant | 317 Broadway Suite A, Amytyville, NY 11701 | 2017-01-20 |
| 1598129710 | Yoko Shiraiwa | Nurse Practitioner | 78 Ocean Avenue, Amityville, NY 11701 | 2016-04-13 |
| 1891158820 | Grace Ann Budde | Health Educator | 30 S Ireland Pl, Amityville, NY 11701 | 2016-03-29 |
| 1720445497 | Sabrina A Rahman | Pharmacist | 355 A Broadway, Amityville, NY 11701 | 2016-01-26 |
| 1902245335 | Darlene Marie Mccurty | Specialist | 125 Larsen Dr, Amityville, NY 11701 | 2013-06-19 |
| 1457613507 | Edria Parks | Specialist | 14 Wanser Pl, Amityville, NY 11701 | 2012-06-14 |
| Find all providers in zip 11701 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760608 | Shanequa Marshall | Licensed Practical Nurse | 100 Park Ave Apt 1, Amityville, NY 11701-3165 | 2020-11-05 |
| 1144860859 | Kimone Hinds-thomas | Licensed Practical Nurse | 365 Broadway Ste 4a, Amityville, NY 11701-2716 | 2020-01-10 |
| 1184268898 | Bonnie Epps | Licensed Practical Nurse | 28 Park Ave Apt 6, Amityville, NY 11701-3156 | 2019-11-06 |
| 1780227645 | Somone Monique Pernell | Licensed Practical Nurse | 456 Bayview Ave, Amityville, NY 11701-2631 | 2019-10-23 |
| 1619443355 | Sharrell M James | Licensed Practical Nurse | 474 Bayview Ave, Amityville, NY 11701-2628 | 2018-10-20 |
| 1184115487 | Sasheka Samantha Smith | Licensed Practical Nurse | 19 E Avon Dr, Amityville, NY 11701-2023 | 2018-05-22 |
| 1851893200 | Esther Wilma Vickers | Licensed Practical Nurse | 65 Walnut Rd, Amityville, NY 11701-1022 | 2018-03-01 |
| 1679090211 | Amber Collins | Licensed Practical Nurse | 16 Penndale Dr, Amityville, NY 11701-2026 | 2017-08-24 |
| 1538690581 | Michelle Hopkins-green | Licensed Practical Nurse | 69 Cedar Rd, Amityville, NY 11701-1303 | 2017-03-22 |
| 1245785435 | Charnell Gulley | Licensed Practical Nurse | 28 Walnut Rd, Amityville, NY 11701-1021 | 2016-08-17 |
| Find all providers in AMITYVILLE | ||||
| City | AMITYVILLE |
| Zip Code | 11701 |
Please comment or provide details below to improve the information on MR. ANTHONY DEMETRIUS FULLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.