Provider Demographics
NPI:1053036905
Name:FULLER, OLGA GULYAYEVA (PHD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:GULYAYEVA
Last Name:FULLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3009
Mailing Address - Country:US
Mailing Address - Phone:347-201-0492
Mailing Address - Fax:
Practice Address - Street 1:31 W 34TH ST
Practice Address - Street 2:8TH FL., PMB #8093
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3009
Practice Address - Country:US
Practice Address - Phone:347-201-0492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist