Healthcare Provider Details

I. General information

NPI: 1316947773
Provider Name (Legal Business Name): GINGER ELIZABETH FULLER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ALLEGHENY CTR 8TH FL AGH NEUROPSYCH TESTING
PITTSBURGH PA
15212-5255
US

IV. Provider business mailing address

4 ALLEGHENY CTR 8TH FL AGH NEUROPSYCH TESTING
PITTSBURGH PA
15212-5255
US

V. Phone/Fax

Practice location:
  • Phone: 412-330-4000
  • Fax: 412-330-4366
Mailing address:
  • Phone: 412-330-4000
  • Fax: 412-330-4366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW010354L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: