Provider Demographics
NPI:1881676138
Name:FUSCO, ROBERT D (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:FUSCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:725 CHERRINGTON PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4318
Mailing Address - Country:US
Mailing Address - Phone:412-262-1000
Mailing Address - Fax:412-262-4607
Practice Address - Street 1:725 CHERRINGTON PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-4318
Practice Address - Country:US
Practice Address - Phone:412-262-1000
Practice Address - Fax:412-262-4607
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2010-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD018867E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007728510005Medicaid
PA101621NYBMedicare ID - Type Unspecified
PAC29994Medicare UPIN