Provider Demographics
NPI:1841204997
Name:FUCIGNA, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:FUCIGNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MILL RIVER ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3725
Mailing Address - Country:US
Mailing Address - Phone:203-348-7573
Mailing Address - Fax:203-348-2893
Practice Address - Street 1:70 MILL RIVER ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3725
Practice Address - Country:US
Practice Address - Phone:203-348-7573
Practice Address - Fax:203-348-2893
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT035457207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG10667Medicare UPIN
CT180000761Medicare ID - Type Unspecified