# MRS. LENNI FUGAZY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1619922481
- **Gender:** F
- **Credential:** P.A.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA9104242 | FL | — |
| 363AS0400X | Surgical Physician Assistant | 085002149 | IL | Yes |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 01/12/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1633878 | BCBS PPO | IL |
| 05 | — | 292866300 | — | FL |
| 01 | — | P00990032 | RR MEDICARE | IL |