Provider Demographics
NPI:1235762584
Name:FUSARO, BRANDON M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:M
Last Name:FUSARO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-1471
Mailing Address - Country:US
Mailing Address - Phone:774-232-9545
Mailing Address - Fax:
Practice Address - Street 1:110 WORCESTER RD
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:MA
Practice Address - Zip Code:01564-1471
Practice Address - Country:US
Practice Address - Phone:774-232-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist