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General NPI Number Information
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NPI Number | 1578483285
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Entity Type | Individual
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Provider Name | FISNIK ISUFI LAT, ATC, MBA
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Gender | Male
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 1000 RIVER RD
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City | TEANECK
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State | NJ
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Zip | 07666-1938
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Country | US
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Telephone | 877-338-8002
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Fax |
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Provider Business Mailing Address
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Address Line | 633 PALISADE AVE APT 2C
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City | CLIFFSIDE PARK
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State | NJ
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Zip | 07010-3078
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Country | US
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Telephone | 551-574-7559
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00347900
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License Number State | NJ
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