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Individual

NICOLE FUSARO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT PRACTITIONER

Contact information

Practice address
15 CLOVE WAY, STATEN ISLAND, NY 10301-3634
(718) 437-2227
Mailing address
15 CLOVE WAY, STATEN ISLAND, NY 10301-3634
(718) 437-0107

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007755-1
NY

Other

Enumeration date
10/23/2013
Last updated
03/11/2014
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