MEDICARE: ROBERT FULOP, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1174709190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT FULOP, M.D., P.C.

Provider Business Mailing Address
First Line	:	476 KLONDIKE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-6216
Country	:	US
Telephone Number	:	718-761-1156
Fax Number	:

Provider Business Practice Location Address
First Line	:	476 KLONDIKE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-6216
Country	:	US
Telephone Number	:	718-761-1156
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT FULOP
Credential	:	MD
Telephone Number	:	718-761-1156

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	01/22/2008

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