Provider Demographics
NPI:1184886772
Name:FUSCHETTI, NANCY EGAN (LPTA)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:EGAN
Last Name:FUSCHETTI
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 BISHOPSGATE LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6181
Mailing Address - Country:US
Mailing Address - Phone:757-498-0705
Mailing Address - Fax:
Practice Address - Street 1:873 BISHOPSGATE LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6181
Practice Address - Country:US
Practice Address - Phone:757-498-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306602182225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant