Healthcare Provider Details

I. General information

NPI: 1295723757
Provider Name (Legal Business Name): LAWRENCE M FECHTNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DRIVE
FLEMINGTON NJ
08822
US

IV. Provider business mailing address

1 WESCOTT DRIVE STE 102
FLEMINGTON NJ
08822
US

V. Phone/Fax

Practice location:
  • Phone: 908-237-1148
  • Fax: 908-237-1318
Mailing address:
  • Phone: 908-237-1148
  • Fax: 908-237-1318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMA64361
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA64361
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: