MEDICARE: STEFANO FUSI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	028104	CT
2	2082S0099X	Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician	028104	CT
3	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	028104	CT
4	2086S0105X	Surgery of the Hand (Surgery) Physician	028104	CT
5	2086S0122X	Plastic and Reconstructive Surgery Physician	028104	CT

General Provider Information

NPI Number	:	1336185883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANO FUSI MD

Provider Business Mailing Address
First Line	:	5 DURHAM RD
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-2076
Country	:	US
Telephone Number	:	203-458-4444
Fax Number	:	203-458-4447

Provider Business Practice Location Address
First Line	:	5 DURHAM RD
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-2076
Country	:	US
Telephone Number	:	203-458-4444
Fax Number	:	203-458-4447

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	11/02/2010

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Directions to “ STEFANO FUSI MD” Practice Location

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