Individual
PETER FUSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 JEFFERSON AVE APT 5, AVON BY THE SEA, NJ 07717-1165
(973) 714-1467
Mailing address
520 JEFFERSON AVE APT 5, AVON BY THE SEA, NJ 07717-1165
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00206600
NJ
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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