Active NPI
Giancarlo Fusco, PSYD
- Health Service Psychologist
- Newton, MA
National Provider Identifier
1497088215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- 9963
- Practice address
- 193 Oak St
Suite 1
Newton, MA 02464-1457 - Phone
- (617) 685-5600
- NPI assigned
- Sep 11, 2009
- Last updated
- Aug 21, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | 9963 | MA | Primary |
Addresses
Primary practice location
193 Oak St
Suite 1
Newton, MA 02464-1457
Mailing address
104 Marble St
Stoneham, MA 02180-2736
Phone (617) 549-7263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9963 | MA | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408579200000",
"number": "1497088215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 MARBLE ST",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021802736",
"telephone_number": "617-549-7263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "193 OAK ST",
"address_2": "SUITE 1",
"city": "NEWTON",
"state": "MA",
"postal_code": "024641457",
"telephone_number": "617-685-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSCO",
"first_name": "GIANCARLO",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-11",
"last_updated": "2014-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MA",
"license": "9963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.