Healthcare Provider Details

I. General information

NPI: 1558600999
Provider Name (Legal Business Name): FELIX ALEJANDRO FRISCHEISEN M.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 KEARNY AVE
KEARNY NJ
07032-3211
US

IV. Provider business mailing address

218 OVERLOOK AVE
BELLEVILLE NJ
07109-2271
US

V. Phone/Fax

Practice location:
  • Phone: 201-428-1550
  • Fax:
Mailing address:
  • Phone: 973-901-4798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18KT00406800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: