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General NPI Number Information
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NPI Number | 1386394310
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Entity Type | Organization
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Legal Business Name | FUSION RECOVERY CENTERS
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 444 BROADWAY
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City | MENANDS
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State | NY
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Zip | 12204-2887
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Country | US
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Telephone | 518-539-4931
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Fax |
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Provider Business Mailing Address
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Address Line | 130 CENTRAL AVE
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City | LAWRENCE
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State | NY
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Zip | 11559-1332
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Country | US
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Telephone | 917-873-1222
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | YOEL GARBER
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Credential |
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Telephone | 917-873-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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