Provider Demographics
NPI:1528291499
Name:FUSINA, LAURA (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:FUSINA
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 GLENBROOK RD APT 4111
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-8406
Mailing Address - Country:US
Mailing Address - Phone:617-308-1562
Mailing Address - Fax:
Practice Address - Street 1:1554 NORTHERN BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3006
Practice Address - Country:US
Practice Address - Phone:516-365-3996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS