Fusunyan, Robert D
Fusunyan, Robert D is an sole proprietor health care provider with primary practice located at 40 2Nd Avenue Suite 340, Waltham MA 02451-1132. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Fusunyan, Robert D can be contacted via phone (781) 466-8967.Contact Information
Primary practice address
40 2Nd Avenue Suite 340
Waltham MA 02451-1132
Phone: (781) 466-8967
Fax: (781) 466-8987
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 78425 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | 78425 | Massachusetts |
Profile Details
| NPI number | 1104817717 |
|---|---|
| LBN Legal business name | Fusunyan, Robert D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Sep 3rd, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104817717 | NPPES |
| Massachusetts | Other | 750032 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 3159337 | TUFTS HEALTH PLAN |
| Massachusetts | Other | J17154 | TUFTS HEALTH PLAN |
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