Provider Demographics
NPI:1154998854
Name:FUSCO, KELSEY M (MS)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:M
Last Name:FUSCO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SURREY LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-4412
Mailing Address - Country:US
Mailing Address - Phone:413-841-8301
Mailing Address - Fax:
Practice Address - Street 1:155 BORTHWICK AVE STE 303
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7156
Practice Address - Country:US
Practice Address - Phone:413-841-8301
Practice Address - Fax:207-303-3234
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0005170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS