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General NPI Number Information
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NPI Number | 1295855518
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Entity Type | Individual
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Provider Name | MARY LOU FUSI APRN
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 495 CONGRESS AVE 3RD FLOOR
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City | NEW HAVEN
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State | CT
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Zip | 06519-1312
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Country | US
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Telephone | 203-781-4640
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Fax |
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Provider Business Mailing Address
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Address Line | 297 NECK RD
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City | MADISON
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State | CT
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Zip | 06443-2755
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Country | US
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Telephone | 203-245-9106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 002160
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License Number State | CT
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