Provider Demographics
NPI:1689947566
Name:FUSCO, ANN-MARIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANN-MARIA
Middle Name:
Last Name:FUSCO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 COBBLER CT
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8767
Mailing Address - Country:US
Mailing Address - Phone:209-544-8259
Mailing Address - Fax:209-544-8259
Practice Address - Street 1:4601 DALE RD
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9718
Practice Address - Country:US
Practice Address - Phone:209-735-6962
Practice Address - Fax:209-735-3007
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist