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Individual

MR. JONATHAN R FUGO-TUTALO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
92 OLD ROUTE 9W, SUITE 100, NEW WINDSOR, NY 12553-5485
(845) 565-7040
(845) 565-7060
Mailing address
92 OLD ROUTE 9W, SUITE 100, NEW WINDSOR, NY 12553-5485
(845) 565-7040
(845) 565-7060

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
260705
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03372070
NY
Enumeration date
07/18/2007
Last updated
06/13/2024
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