Healthcare Provider Details

I. General information

NPI: 1841910205
Provider Name (Legal Business Name): CONOR FIEGGEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 HAMBURG TPKE
WAYNE NJ
07470-6297
US

IV. Provider business mailing address

11 EAGLE ROCK AVE
EAST HANOVER NJ
07936-3167
US

V. Phone/Fax

Practice location:
  • Phone: 973-835-0909
  • Fax:
Mailing address:
  • Phone: 973-887-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: