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Individual

MRS. TAMMY LOUISE FUSCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
5240 BROOKHAVEN DR, CLARENCE, NY 14031-1612
(716) 759-6707
Mailing address
691 MAPLE RD, EAST AURORA, NY 14052-1025
(716) 655-6393

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
369-396-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02666851
NY
Enumeration date
07/30/2007
Last updated
07/30/2007
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