Provider Demographics
NPI:1780045922
Name:FUSCO, ANDRIA MAGLIOZZI (LAC, NBCC,)
Entity Type:Individual
Prefix:MRS
First Name:ANDRIA
Middle Name:MAGLIOZZI
Last Name:FUSCO
Suffix:
Gender:F
Credentials:LAC, NBCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 MORNINGSIDE RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1600
Mailing Address - Country:US
Mailing Address - Phone:908-451-1150
Mailing Address - Fax:
Practice Address - Street 1:138 MORNINGSIDE RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1600
Practice Address - Country:US
Practice Address - Phone:908-451-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00176400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health