Provider Demographics
NPI:1285330902
Name:RICHARDS-FUSCO, CASSANDRA LORRAINE
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:LORRAINE
Last Name:RICHARDS-FUSCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 BALDWIN RD APT B5
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2016
Mailing Address - Country:US
Mailing Address - Phone:973-819-9689
Mailing Address - Fax:
Practice Address - Street 1:270 BALDWIN RD APT B5
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-2016
Practice Address - Country:US
Practice Address - Phone:973-819-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00299500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist