Healthcare Provider Details

I. General information

NPI: 1154461655
Provider Name (Legal Business Name): KENJI P FUJITA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PATERSON ST CLINICAL ACADEMIC BUILDING, SUITE 2300
NEW BRUNSWICK NJ
08901-1962
US

IV. Provider business mailing address

125 PATERSON ST CLINICAL ACADEMIC BUILDING, SUITE 2300
NEW BRUNSWICK NJ
08901-1962
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-7112
  • Fax: 732-235-7114
Mailing address:
  • Phone: 732-235-7112
  • Fax: 732-235-7114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA07922400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA07922400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: