Provider Demographics
NPI:1598447146
Name:FUSE MEDICAL PC
Entity Type:Organization
Organization Name:FUSE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:ILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIZH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-898-6734
Mailing Address - Street 1:25 SAVIN CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4215
Mailing Address - Country:US
Mailing Address - Phone:646-898-6734
Mailing Address - Fax:
Practice Address - Street 1:154 STATE ROUTE 10
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-2107
Practice Address - Country:US
Practice Address - Phone:973-920-3090
Practice Address - Fax:973-920-3091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty