Provider Demographics
NPI:1780398982
Name:FUSTER, ALMA INES
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:INES
Last Name:FUSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 NW 53RD ST APT 360
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4834
Mailing Address - Country:US
Mailing Address - Phone:609-705-5882
Mailing Address - Fax:
Practice Address - Street 1:714 W WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08215-3838
Practice Address - Country:US
Practice Address - Phone:609-385-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06887200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker