Healthcare Provider Details

I. General information

NPI: 1679828396
Provider Name (Legal Business Name): MR. HILLEL FISCHMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 JULIUS WAY
LAKEWOOD NJ
08701-6162
US

IV. Provider business mailing address

88 WADSWORTH AVE
LAKEWOOD NJ
08701-6136
US

V. Phone/Fax

Practice location:
  • Phone: 856-827-7630
  • Fax:
Mailing address:
  • Phone: 732-363-1367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-49653
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: