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General NPI Number Information
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NPI Number | 1245715812
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Entity Type | Individual
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Provider Name | DAVID ERIC FIXLER PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/30/2018
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Last Update Date | 09/30/2018
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Provider Practice Location Address
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Address Line | 3499 US 9 STE 2B
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City | FREEHOLD
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State | NJ
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Zip | 07728-3277
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Country | US
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Telephone | 732-625-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 39 CLARA ST
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City | NORTH HALEDON
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State | NJ
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Zip | 07508-2314
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Country | US
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Telephone | 636-512-2610
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00489000
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License Number State | NJ
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