MEDICARE: MRS. ERIN LANG FUCCI

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	225100000X	Physical Therapist	40QA00623600	NJ

General Provider Information

NPI Number	:	1700088549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN LANG FUCCI

Provider Business Mailing Address
First Line	:	215 E VINEYARD CT
Second Line	:
City	:	CAPE MAY
State	:	NJ
Zip	:	08204-4277
Country	:	US
Telephone Number	:	609-898-2293
Fax Number	:

Provider Business Practice Location Address
First Line	:	3860 BAYSHORE RD
Second Line	:	BACHARACH REHABILITATION
City	:	NORTH CAPE MAY
State	:	NJ
Zip	:	08204-3260
Country	:	US
Telephone Number	:	609-770-7804
Fax Number	:	609-770-7853

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

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	05/12/2017

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