Provider Demographics
NPI:1689255036
Name:FUCCI, SELENA (PA-C)
Entity Type:Individual
Prefix:
First Name:SELENA
Middle Name:
Last Name:FUCCI
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:19 SWALLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1951
Mailing Address - Country:US
Mailing Address - Phone:267-566-6320
Mailing Address - Fax:
Practice Address - Street 1:3120 PRINCETON PIKE FL 2
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2325
Practice Address - Country:US
Practice Address - Phone:609-896-1701
Practice Address - Fax:609-896-3735
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2024-01-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical