Provider Demographics
NPI:1093068124
Name:DR. ANTHONY FUSCO & ASSOCIATES
Entity Type:Organization
Organization Name:DR. ANTHONY FUSCO & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FUSCO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-647-8247
Mailing Address - Street 1:PO BOX 107
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03037-0107
Mailing Address - Country:US
Mailing Address - Phone:603-647-8247
Mailing Address - Fax:603-898-1534
Practice Address - Street 1:6 MARCH AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4012
Practice Address - Country:US
Practice Address - Phone:603-647-8247
Practice Address - Fax:603-898-1534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty