Healthcare Provider Details

I. General information

NPI: 1396125324
Provider Name (Legal Business Name): CHRISTINE PFISTERER, DO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 PALISADE AVE SUITE #205
TEANECK NJ
07666-3419
US

IV. Provider business mailing address

870 PALISADE AVE SUITE #205
TEANECK NJ
07666-3419
US

V. Phone/Fax

Practice location:
  • Phone: 201-836-1663
  • Fax:
Mailing address:
  • Phone: 201-836-1663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MB09346000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number25MB09346000
License Number StateNJ

VIII. Authorized Official

Name: CHRISTINE PFISTERER
Title or Position: PHYSICIAN
Credential: DO
Phone: 201-836-1663