Provider Demographics
NPI:1376530436
Name:FUSCO, ROBERT ALLAN SR (RPH CCP FASCP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLAN
Last Name:FUSCO
Suffix:SR
Gender:M
Credentials:RPH CCP FASCP
Other - Prefix:
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Mailing Address - Street 1:34 OCEAN DR W
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-1134
Mailing Address - Country:US
Mailing Address - Phone:609-266-7990
Mailing Address - Fax:856-428-9449
Practice Address - Street 1:1951 OLD CUTHBENT RD
Practice Address - Street 2:STE 306
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1411
Practice Address - Country:US
Practice Address - Phone:856-428-3939
Practice Address - Fax:856-428-9449
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ28RI01260000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist