Ito Fukunaga, Mayuko

Ito Fukunaga, Mayuko is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Ito Fukunaga, Mayuko can be contacted via phone (508) 334-1975.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 268768 Massachusetts
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 268768 Massachusetts

Profile Details

NPI number 1881804557
LBN Legal business name Ito Fukunaga, Mayuko
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jun 7th, 2024 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1881804557 NPPES
Massachusetts MEDICAID 110118566A

Popular Providers