Constance Fullwood, PHNL, PMHNP-BC
Nurse Practitioner (CMS) · Long Island City, NY
At a glance
36-11 21St St, Long Island City, NY 11106-4505
NPPES record updated Aug 5, 2026. Public records can lag behind changes at a practice.
Before you call: a quick checklist
- Are you accepting new patients?
- Do you accept my specific insurance plan?
- Do you provide the service I need at this address?
- Do I need a referral, and what is the earliest appointment?
Insurance participation and appointment availability are not established by these public records.
Medicare & insurance
Insurance participation is not established by these public records. Ask the practice and your insurer about your specific plan and this location.
How to check your coverage
Use your plan’s provider directory or the member-services number on your insurance card. Confirm the clinician, practice address, service, and whether a referral is required. A missing opt-out record does not establish Medicare acceptance.
Check the official Medicare directory ↗Practice location
36-11 21St StLong Island City, NY 11106-4505
Additional reported practice locations
94-98 Manhattan AvenueBrooklyn, NY 112062505
Phone: 7183880390
Fax: 7184865741 255 E Houston St
New York, NY 100021013
Phone: 2124771120
Fax: 2124778957 350 Grand St Rm 240
New York, NY 100024629
Phone: 2126347550 · Ext. 7556 89-44 164Th St
Jamaica, NY 114326103
Phone: 7185232123
Fax: 7185235833 1880 Bathgate Ave
Bronx, NY 104576259
Phone: 7182945891
Fax: 7182942468 504 W 158Th St Fl 5
New York, NY 100327202
Phone: 9175213130 · Ext. 3130 2581 Atlantic Ave
Brooklyn, NY 112072412
Phone: 7184956700
Fax: 6469882840 1167 Nostrand Ave
Brooklyn, NY 112255417
Phone: 7187780198
Fax: 7182218169 999 Blake Ave
Brooklyn, NY 112083535
Phone: 7182778303
Fax: 7182774795 2301 Dorsey Rd Ste 200
Glen Burnie, MD 210613275
Phone: 4107680123 81 W 115Th St
New York, NY 100263138
Phone: 2124260088
Fax: 2124268367 975 Westchester Ave
Bronx, NY 104593204
Phone: 7183204466
Fax: 7189913829 511 W 157Th St
New York, NY 100325058
Phone: 2127817979
Fax: 2127817963
Education & affiliations
- Medical / professional school
- Not reported in this file
- Graduation year
- 2020
- CMS specialties
- Nurse Practitioner
CMS reports telehealth services for this clinician. Confirm current services and availability with the practice.
Practice groups
Graduation year does not establish years in practice. A reported affiliation does not establish employment, current admitting privileges, or insurance participation.
Source: CMS National Downloadable File · Published Oct 15, 2026.
Procedures in the public data
Reported activity can help you ask more informed questions about a practice’s services.
No displayed procedure-category record in this release. This does not mean the clinician performs no procedures.
CMS uses a one-year claims window with a reporting lag. Counts cover the Medicare activity included by CMS, not all patients. “1–10” is a published range. Volume is not a quality or outcomes score. Coverage and methodology
Source: CMS Utilization Data · Published Oct 15, 2026.
Service-mix comparison is unavailable for this NPI in the imported Medicare service file.
Industry-reported general payments
No matching general-payment summary in the imported release. This is not a verified zero and does not rule out other payment types or years.
Source: CMS 2025 payments grouped by covered recipient and nature of payments · Published Jun 30, 2026.
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Nurse Practitioner (CMS)
- Taxonomy code
- 363LP0808X
- Enumeration date
- Jun 19, 2021
- Record updated
- Aug 5, 2026
More registry details
- Provider type
- Individual · Type 1
- Reported credentials
- PHNL, PMHNP-BC
Reported taxonomies and licenses
363LP0808X
License reported: RN250856 MA
363LP0808X · Primary
License reported: F405449-01 NY
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
36-11 21St StLong Island City, NY 11106-4505
- Phone
- (718) 482-7772
- Fax
- (718) 482-9648
Mailing address
1125 WEST ST # 401ANNAPOLIS, MD 214014198
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
Report a directory issue