Healthcare Provider Details
I. General information
NPI: 1437293180
Provider Name (Legal Business Name): MAGDALENA ANISKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/16/2007
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
42 LOCUST AVE FRNT SUITE
WALLINGTON NJ
07057-1300
US
IV. Provider business mailing address
42 LOCUST AVE FRNT SUITE
WALLINGTON NJ
07057-1300
US
V. Phone/Fax
- Phone: 973-473-4033
- Fax: 973-473-2988
- Phone: 973-473-4033
- Fax: 973-473-2988
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | MA071337 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: