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Individual

IREAL JOHNSON FUSCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 899-9511
Mailing address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
324028
LA
208000000X
Pediatrics Physician
R2369
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
324028
LA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
R2369
TX

Other

Enumeration date
05/06/2014
Last updated
12/17/2024
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