Individual provider · Type 1 NPI

Sidni B. Jay Fullerton, MD

Student in an Organized Health Care Education/Training Program · Englewood, NJ

NPI number 1811745409 Active · reactivated Feb 19, 2025

Practice location

350 Engle Street Department Of Medicine,
Englewood, NJ 07631

Call (201) 894-3143 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1811745409

Sidni B. Jay Fullerton, MD's National Provider Identifier is 1811745409, issued on May 8, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Englewood, NJ. The record was last updated on Feb 19, 2025.