Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 171779 | NY |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD029759E | PA |
NPI | 1053305581 |
---|---|
Provider Name | Laszlo Fuzesi |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 10/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02105439 | (05) | NY |
E53172 | (02) | |
J400241845 | (02) | NY |
P00202971 | RR MEDICARE (01) | NY |