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General NPI Number Information
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NPI Number | 1881843639
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Entity Type | Organization
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Legal Business Name | GLENCOVE OBGYN ASSOCIATES
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 50 SCHOOL ST SUITE 2
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City | GLEN COVE
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State | NY
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Zip | 11542-2534
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Country | US
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Telephone | 516-671-5197
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Fax | 516-671-5231
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Provider Business Mailing Address
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Address Line | 50 SCHOOL ST SUITE 2
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City | GLEN COVE
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State | NY
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Zip | 11542-2534
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Country | US
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Telephone | 516-671-5197
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Fax | 516-671-5231
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Authorized Official
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Title or Position | PHYSCIAN
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Name | DR. GEORGE THURMAN FULMER JR.
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Credential | M.D.
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Telephone | 516-671-5197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 113417
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License Number State | NY
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