Healthcare Provider Details

I. General information

NPI: 1447673108
Provider Name (Legal Business Name): NICHOLAS FISCHETTI RD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 06/12/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33-41 NEWARK ST FL 5
HOBOKEN NJ
07030-5627
US

IV. Provider business mailing address

33-41 NEWARK ST FL 5
HOBOKEN NJ
07030-5627
US

V. Phone/Fax

Practice location:
  • Phone: 917-647-1665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: