Provider Demographics
NPI:1598998049
Name:GILDAY, EDA FUSCO (RN MSN CEN)
Entity Type:Individual
Prefix:MRS
First Name:EDA
Middle Name:FUSCO
Last Name:GILDAY
Suffix:
Gender:F
Credentials:RN MSN CEN
Other - Prefix:MS
Other - First Name:EDA
Other - Middle Name:SHARON
Other - Last Name:FUSCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:263 ALDEN STREET
Mailing Address - Street 2:SPRINGFIELD COLLEGE HEALTH CENTER
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-3707
Mailing Address - Country:US
Mailing Address - Phone:413-748-3175
Mailing Address - Fax:413-748-3444
Practice Address - Street 1:263 ALDEN STREET
Practice Address - Street 2:SPRINGFIELD COLLEGE HEALTH CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3707
Practice Address - Country:US
Practice Address - Phone:413-748-3175
Practice Address - Fax:413-748-3444
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121478363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics