Keydella Fuller (NPI# 1053855809, PAC ID# 8123303047) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1053855809 |
| PAC ID by PECOS | 8123303047 |
| Professional Enrollment ID | I20170316000114 |
| Full Name | Keydella Fuller |
| Organization Legal Name | SAMIR JAIN MD PC |
| Address |
1608 Route 88 W Suite 104b Brick NJ 08724-3009 |
| Phone Number | 7326089737 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3072656537 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310041 | COMMUNITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1608 Route 88 W, Suite 104b, Brick, NJ 08724-3009 | 7326089737 | SAMIR JAIN MD PC |
| 2006 Route 35, Spring Lake, NJ 07762-2543 | 7322820719 | MERIDIAN MEDICAL GROUP-RETAIL CLINIC PC |
| 599 Route 37 W, Suite 5, Toms River, NJ 08755-8011 | 7326089737 | SAMIR JAIN MD PC |
| Organization Legal Name | SAMIR JAIN MD PC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samir S Jain | Cardiovascular Disease (cardiology) | Samir Jain Md PC | 1608 Route 88 W, Suite 104b, Brick, NJ 08724-3009 |
| Mihaela Michael | Nurse Practitioner | Samir Jain Md PC | 1608 Route 88 W, Suite 104b, Brick, NJ 08724-3009 |
| Street Address |
1608 ROUTE 88 W SUITE 104B |
| City | BRICK |
| State | NJ |
| Zip | 08724-3009 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dharam P Mann | Interventional Pain Management | Garden State Medical Center, LLC | 1608 Route 88 W, Suite 102, Brick, NJ 08724-3009 |
| Daniel Winston | Oral Surgery | Coastal Oral Surgery, Pa | 1608 Route 88 W, Suite 101, Brick, NJ 08724-3009 |
| Jayne Pavlak-schenk | Medical Oncology | New Jersey Hematology Oncology Associates, LLC | 1608 Route 88 W, Suite 250, Brick, NJ 08724-3044 |
| Girish S Amin | Hematology/oncology | New Jersey Hematology Oncology Associates, LLC | 1608 Route 88 W, Suite 250, Brick, NJ 08724-3044 |
| Samir S Jain | Cardiovascular Disease (cardiology) | Samir Jain Md PC | 1608 Route 88 W, Suite 104b, Brick, NJ 08724-3009 |
| Mihaela Michael | Nurse Practitioner | Samir Jain Md PC | 1608 Route 88 W, Suite 104b, Brick, NJ 08724-3009 |
| Yoonchan P Han | Maxillofacial Surgery | Coastal Oral Surgery, Pa | 1608 Route 88 W, Brick, NJ 08724-3009 |
| Robert Mustich | Physical Therapy | 1608 Route 88 W, Suite 201, Brick, NJ 08724-3044 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sandy Everett | Occupational Therapy | Bancroft Rehabilitation Services | 1608 New Jersey, Brick, NJ 08724 |
| James E Rotolo | Urology | James E. Rotolo, M.d., F.a.c.s., P.a. | 1696 Route 88 1st, Brick, NJ 08724 |
| Donna M Merchant | Qualified Audiologist | 1673 Rt 88, Brick, NJ 08724 | |
| Sharon S Smith-tumpey | Chiropractic | 142 Natick Trail, Brick, NJ 08724 | |
| Bridget N Bielskie | Physical Therapy | Sportscare of America, PC | 1161 Burnt Tavern Rd, Brick, NJ 08724-1472 |
| Darlene Morgan | Obstetrics/gynecology | Brick Women's Physicians | 1140 Burnt Tavern Rd, Suite 2a, Brick, NJ 08724-1496 |
| Paul Vetter | Obstetrics/gynecology | Brick Women's Physicians | 1140 Burnt Tavern Rd, Suite 2a, Brick, NJ 08724-1496 |
| Peter A Ottone | Chiropractic | 1140 Burnt Tavern Rd, Suite 1c, Brick, NJ 08724-1496 | |
| Ann M Pagano | Obstetrics/gynecology | Brick Women's Physicians | 1140 Burnt Tavern Rd, Suite 2a, Brick, NJ 08724-1496 |
| Tracy Goldych | Chiropractic | 1140 Burnt Tavern Rd, 1c, Brick, NJ 08724-1496 | |
| Find all physicians in zip 08724 | |||
| City | BRICK |
| Zip Code | 08724 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BRICK + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Keydella Fuller.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.