Healthcare Provider Details

I. General information

NPI: 1073583720
Provider Name (Legal Business Name): JOHN F FISHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 E MAIN ST JOHN F FISHER MD PA
SUSSEX NJ
07461
US

IV. Provider business mailing address

16 E MAIN ST
SUSSEX NJ
07461
US

V. Phone/Fax

Practice location:
  • Phone: 973-875-3646
  • Fax: 973-875-2021
Mailing address:
  • Phone: 973-875-3646
  • Fax: 973-875-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA04056400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: