Healthcare Provider Details

I. General information

NPI: 1932165701
Provider Name (Legal Business Name): MARGARET C FISHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 10/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 2ND AVE
LONG BRANCH NJ
07740-6303
US

IV. Provider business mailing address

PO BOX 8000 DEPT 601
BUFFALO NJ
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 732-923-7251
  • Fax: 732-923-7255
Mailing address:
  • Phone: 866-295-0041
  • Fax: 708-342-2517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number25MA07136300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: