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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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