Individual provider · NPI-1

Cassie Lynn Fuller, Au.D.

Audiologist · Bronx, NY

NPI number1316489602
StatusActive
Last updated in NPPESNov 17, 2016

Details

NPI
1316489602
Entity type
Individual (NPI-1)
Name
Cassie Lynn Fuller
Credential
Au.D.
Sex
Female
Sole proprietor
No
Enumeration date
Nov 17, 2016
Last updated
Nov 17, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
231H00000X Audiologist002687-1NYYes
237600000X Audiologist-Hearing Aid Fitter14000049486NY

Practice location

1934 Williamsbridge Rd
Bronx, NY 10461-1638

Phone 718-822-4100 · Fax 718-829-1350

Mailing address

1934 Williamsbridge Rd
Bronx, NY 10461-1638

Phone 718-822-4100 · Fax 718-829-1350

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