Provider Demographics
NPI:1275548075
Name:TUSINSKI, ROMAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:K
Last Name:TUSINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:340 THOMPSON RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-1509
Mailing Address - Country:US
Mailing Address - Phone:508-943-5132
Mailing Address - Fax:508-943-5209
Practice Address - Street 1:340 THOMPSON RD
Practice Address - Street 2:SUITE 108
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-1509
Practice Address - Country:US
Practice Address - Phone:508-943-5132
Practice Address - Fax:508-943-5209
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA250351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine