Provider Demographics
NPI:1881213239
Name:FUCHS, GINA LEE (LCAT-LP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:LEE
Last Name:FUCHS
Suffix:
Gender:F
Credentials:LCAT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 S FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5622
Mailing Address - Country:US
Mailing Address - Phone:516-528-2558
Mailing Address - Fax:
Practice Address - Street 1:35 S FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5622
Practice Address - Country:US
Practice Address - Phone:516-528-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty