Provider Demographics
NPI:1891890554
Name:FUEG, ADRIENNE (MD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:FUEG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CROSFIELD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2222
Mailing Address - Country:US
Mailing Address - Phone:845-535-3362
Mailing Address - Fax:845-535-3368
Practice Address - Street 1:1 CROSFIELD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2222
Practice Address - Country:US
Practice Address - Phone:845-535-3362
Practice Address - Fax:845-535-3368
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2040011174400000X
PAMD433138208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02085752Medicaid
NY0822H1Medicare ID - Type Unspecified
NY02085752Medicaid
NYH15108Medicare UPIN