Provider Demographics
NPI:1053305581
Name:FUZESI, LASZLO (MD)
Entity Type:Individual
Prefix:
First Name:LASZLO
Middle Name:
Last Name:FUZESI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:1250 S CEDAR CREST BLVD STE 310
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-402-6890
Practice Address - Fax:610-402-6892
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171779208G00000X
PAMD029759E208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02105439Medicaid
NYP00202971OtherRR MEDICARE
E53172Medicare UPIN
NY02105439Medicaid
NYP00202971OtherRR MEDICARE
NYJ400241845Medicare UPIN