Individual
CYNTHIA R FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3998 RED LION RD, TRAUMA DEPARTMENT, PHILADELPHIA, PA 19114-1445
(215) 612-4064
(215) 612-5438
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-6335
(215) 807-8000
(215) 612-5438
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MB080108
NJ
207P00000X
Emergency Medicine Physician
OS008129L
PA
2086S0127X
Trauma Surgery Physician
Primary
OS008129L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016376610013
—
PA
01
—
2969360
AET NA HMO
PA
01
—
5508477
AETNA PPO
PA
Enumeration date
10/12/2006
Last updated
02/12/2015
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