Provider Demographics
NPI:1376615997
Name:FULOP, DAVID M (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:FULOP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 W BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3340
Mailing Address - Country:US
Mailing Address - Phone:914-698-4411
Mailing Address - Fax:914-698-4486
Practice Address - Street 1:805 W BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3340
Practice Address - Country:US
Practice Address - Phone:914-698-4411
Practice Address - Fax:914-698-4486
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010582-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX5T921Medicare ID - Type Unspecified
NYU94918Medicare UPIN