1093849739 NPI number — ROUTE 53 MEDICAL FAMILY PRACTICE ASSOCIATES, P.A.

Table of content: DANIELLE RAE FISCHER PA (NPI 1801324223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093849739 NPI number — ROUTE 53 MEDICAL FAMILY PRACTICE ASSOCIATES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROUTE 53 MEDICAL FAMILY PRACTICE ASSOCIATES, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093849739
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
891 TABOR RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRIS PLAINS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07950-2733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-359-8859
Provider Business Mailing Address Fax Number:
973-359-8860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
891 TABOR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRIS PLAINS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07950-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-359-8859
Provider Business Practice Location Address Fax Number:
973-359-8860
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CERVONE
Authorized Official First Name:
MAURIZIO
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
973-359-8859

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com