Healthcare Provider Details

I. General information

NPI: 1861685612
Provider Name (Legal Business Name): FISCHER HEALTH & REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 11/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 WASHINGTON AVE
DUMONT NJ
07628-2351
US

IV. Provider business mailing address

158 WASHINGTON AVE
DUMONT NJ
07628-2351
US

V. Phone/Fax

Practice location:
  • Phone: 201-244-8908
  • Fax: 201-244-8907
Mailing address:
  • Phone: 201-244-8908
  • Fax: 201-244-8907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number05142
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QAO1158600
License Number StateNJ

VIII. Authorized Official

Name: DR. CHRISTOPHER T FISCHER
Title or Position: OWNER
Credential: DC
Phone: 201-244-8908