Healthcare Provider Details

I. General information

NPI: 1366818254
Provider Name (Legal Business Name): KATHLEEN RENEE FUSCHI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 LITCHFIELD ST
TORRINGTON CT
06790-6679
US

IV. Provider business mailing address

45 WELLS RD
GRANBY CT
06035-1206
US

V. Phone/Fax

Practice location:
  • Phone: 860-496-6666
  • Fax:
Mailing address:
  • Phone: 203-314-1690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5790
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3447
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: