Provider Demographics
NPI:1679787477
Name:FULFS, JOSEPH M (AUD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:FULFS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 BAGLYOS CIR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8038
Mailing Address - Country:US
Mailing Address - Phone:610-867-7134
Mailing Address - Fax:610-867-7108
Practice Address - Street 1:2851 BAGLYOS CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8038
Practice Address - Country:US
Practice Address - Phone:610-867-7134
Practice Address - Fax:610-867-7108
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001117L237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter