Healthcare Provider Details

I. General information

NPI: 1467895011
Provider Name (Legal Business Name): SARAH JANE FUZESI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 E NORTHFIELD RD
LIVINGSTON NJ
07039-4532
US

IV. Provider business mailing address

45 RENSSELAER RD
ESSEX FELLS NJ
07021-1403
US

V. Phone/Fax

Practice location:
  • Phone: 973-404-9945
  • Fax:
Mailing address:
  • Phone: 973-219-6881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number304242
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA11091500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: