Doctor Name: | DR. MICHAEL FIZICKI |
NPI Number: | 1295766764 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MA39187 |
Business Practice Address: | 192 Hackensack St Unit G East Rutherford, NJ - 070731524 |
Business Phone Number: | 2014608282 |
Business Fax Number: | 3023716655 |
Mailing Address: | 192 Hackensack St, Unit G EAST RUTHERFORD |
State: | NJ |
Postal Code: | 070731524 |
Phone Number: | 2014608282 |
Fax Number: | 3023716655 |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | MA39187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |