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NPI Code Detail

MEDICARE: WAYNE FLEISHHACKER, DO, LLC

MEDICARE: WAYNE FLEISHHACKER, DO, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine Physician

General Provider Information

NPI Number : 1811388432
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAYNE FLEISHHACKER, DO, LLC
Provider Business Mailing Address
First Line : 135 KINNELON RD
Second Line : SUITE 206
City : KINNELON
State : NJ
Zip : 07405-2333
Country : US
Telephone Number : 973-291-8441
Fax Number :
Provider Business Practice Location Address
First Line : 135 KINNELON RD
Second Line : SUITE 206
City : KINNELON
State : NJ
Zip : 07405-2333
Country : US
Telephone Number : 973-291-8441
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. WAYNE FLEISHHACKER
Credential : DO
Telephone Number : 973-291-8442
Provider Enumeration Date : 02/18/2015
Last Update Date : 02/18/2015

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Directions to “WAYNE FLEISHHACKER, DO, LLC ” Practice Location

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