Vincent J Fusella PHD PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

35SI00118000 Issued in NJ

Legal business name

VINCENT J FUSELLA PHD PC

Practice address

One Woodbridge Center
Suite 505
Woodbridge, NJ 07095

Phone

(732) 636-6165

Fax

(732) 636-6172

NPI assigned

Oct 5, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vincent J Fusella, PH.D.NPI 1306987698

Title

President

Phone

(732) 636-6165

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vincent Joseph Fusella, PHD

  • Psychologist
  • Woodbridge, NJ
  • NPI 1306987698
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1255615571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE WOODBRIDGE CENTER",
            "address_2": "SUITE 505",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "07095",
            "telephone_number": "732-636-6165",
            "fax_number": "732-636-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE WOODBRIDGE CENTER",
            "address_2": "SUITE 505",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "07095",
            "telephone_number": "732-636-6165",
            "fax_number": "732-636-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT J FUSELLA PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "FUSELLA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-636-6165",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00118000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1646206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Woodbridge, NJ
• Providers in Woodbridge, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.