Tammy Louise Fusco, R.N.
Individual provider Active NPI Pediatric Registered Nurse · Clarence, NY
NPI 1376733006 · NPPES record last updated Jul 30, 2007
Key facts
- NPI
- 1376733006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Registered Nurse 163WP0200X
- License
- 369-396-1 (NY)
- Practice address
- 5240 Brookhaven Dr
Clarence, NY 14031-1612 - Phone
- (716) 759-6707
- NPI assigned
- Jul 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 369-396-1 | NY | MD | Pediatric Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 369-396-1 | NY | Yes |
Addresses
Primary practice location
5240 Brookhaven Dr
Clarence, NY 14031-1612
Mailing address
691 Maple Rd
East Aurora, NY 14052-1025
Phone (716) 655-6393
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02666851 | Medicaid | NY |
Other providers in Clarence, NY
- Kymberlin Enright
- Frank J Farino
- Umbrine Fatima
- Sharifa Fazili
- Sarah Fritschi
- Pamela Dawn Gallo
- Katherine Nicole Garey
- Helen Gibson
- Rachel Giovannini
- Heather Gordon
All providers in Clarence, NY · Pediatric Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.