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General NPI Number Information
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NPI Number | 1649487471
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Entity Type | Organization
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Legal Business Name | MARK A. FISHER, MD, PA
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 127 PINE ST SUITE 5
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4855
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Country | US
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Telephone | 973-655-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 127 PINE ST SUITE 5
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4855
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Country | US
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Telephone | 973-655-9050
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK A FISHER
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Credential | MD
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Telephone | 973-655-9050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MA68626
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License Number State | NJ
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