DR. ROBERT D FUSUNYAN (NPI# 1104817717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104817717 |
| Entity Type | Individual |
| Full Name | DR. ROBERT D FUSUNYAN |
| Other Name | DR. ROBERT D FU |
| Credential | MD |
| Practice Address |
40 2nd Avenue Suite 340 Waltham MA 02451-1132 |
| Mailing Address |
44 North Street Lexington MA 02420 |
| Practice Telephone | 7814668967 |
| Practice Fax Number | 7814668987 |
| Mailing Telephone | 7818621652 |
| Mailing Fax Number | 7818621652 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2009-09-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 78425 | MA | Allopathic & Osteopathic Physicians |
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
78425 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BCBS MA | J17154 | 01 |
| MA | TUFTS HEALTH PLAN | 750032 | 01 |
| MA | 3159337 | 05 |
| Street Address |
40 2ND AVENUE SUITE 340 |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-1132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467691329 | Wael N. Sayej | Pediatrics | 50 Wason Ave Fl 1, Springfield, MA 01107-1280 | 2009-02-16 |
| 1063674414 | Alexandra N Carey | Pediatrics | 333 Longwood Ave Fl 4, Division of Pediatric Gastroenterology and Nutrition, Boston, MA 02115-5711 | 2008-06-26 |
| 1437335239 | Khoa Dang Tran | Pediatrics | 800 Washington St, Box# 286, Tufts Medical Center, Department of Pediatrics, Boston, MA 02111-1552 | 2008-01-11 |
| 1881700706 | Uzma Shah | Pediatrics | 175 Cambridge Street, Cpzs-575, Boston, MA 02114-2743 | 2006-08-22 |
| 1700803160 | Elizabeth J Hait | Pediatrics | Childrens Hospital, 300 Longwood Avenue, Boston, MA 02115 | 2006-07-15 |
| 1144209446 | William Alian Walker | Pediatrics | 55 Fruit Street B114 3501, Massachusetts General Hospital, Boston, MA 02114 | 2006-01-13 |
| 1265413009 | Anastasios G Angelides | Pediatrics | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2005-11-09 |
| 1891355715 | Kathryn Broyles | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2019-06-13 |
| 1477049468 | Abigail Francis Cross | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2018-07-03 |
| 1356768816 | Jessica Lacy Yasuda | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2014-03-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.