Healthcare Provider Details

I. General information

NPI: 1467569392
Provider Name (Legal Business Name): CARL J PFEIFER PA C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SALEM CT
FLEMINGTON NJ
08822-2034
US

IV. Provider business mailing address

1100 WESCOTT DR SUITE 201
FLEMINGTON NJ
08822-4600
US

V. Phone/Fax

Practice location:
  • Phone: 908-284-0032
  • Fax: 908-328-1846
Mailing address:
  • Phone: 908-788-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052568
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00159900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: