Healthcare Provider Details

I. General information

NPI: 1467317883
Provider Name (Legal Business Name): JULIYA FULMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 OCEAN PKWY
BROOKLYN NY
11235-7869
US

IV. Provider business mailing address

113 TENNENT RD UNIT 519
MORGANVILLE NJ
07751-6220
US

V. Phone/Fax

Practice location:
  • Phone: 718-577-7554
  • Fax:
Mailing address:
  • Phone: 718-577-7554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ15453500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: