Healthcare Provider Details

I. General information

NPI: 1619740388
Provider Name (Legal Business Name): MICHAEL THOMAS FLEMING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 NJ-17
PARAMUS NJ
07652
US

IV. Provider business mailing address

20 PETERSBURG CT
OAK RIDGE NJ
07438-9198
US

V. Phone/Fax

Practice location:
  • Phone: 201-751-2301
  • Fax:
Mailing address:
  • Phone: 973-865-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number25MP00814300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MP00814300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MP00814300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: