Provider Demographics
NPI:1265774392
Name:FULOP, EMILIA ANN (BS)
Entity type:Individual
Prefix:
First Name:EMILIA
Middle Name:ANN
Last Name:FULOP
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 EAST ALFORD RD
Mailing Address - Street 2:
Mailing Address - City:WEST STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01266
Mailing Address - Country:US
Mailing Address - Phone:413-717-0968
Mailing Address - Fax:
Practice Address - Street 1:127 NORTH BEACON STREET
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472
Practice Address - Country:US
Practice Address - Phone:617-926-3600
Practice Address - Fax:617-924-1027
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical