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1750413217 NPI number — MARK S. SOFAIR-FISCH, PHD

NPI Number: 1750413217
Health Care Provider/Practitioner: MARK S. SOFAIR-FISCH, PHD

Information about “1750413217” NPI (MARK S. SOFAIR-FISCH, PHD) exists in 1750413217 in HTML format HTML  |  1750413217 in plain Text format TXT  |  1750413217 in PDF (Portable Document Format) PDF  |  1750413217 in an XML format XML  formats.

NPI Number : 1750413217 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750413217",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MARK S. SOFAIR-FISCH, PHD",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5 ELLIS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEST ORANGE",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07052-3612",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "973-669-3333",
    "MailingAddressFaxNumber": "973-669-9675",
    "FirstLinePracticeLocationAddress": "2737 PRINCETON PIKE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAWRENCEVILLE",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08648-3220",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "609-883-2577",
    "PracticeLocationAddressFaxNumber": "609-883-2092",
    "EnumerationDate": "03/11/2007",
    "LastUpdateDate": "05/13/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SOFAIR-FISCH",
    "AuthorizedOfficialFirstName": "MARK",
    "AuthorizedOfficialMiddleName": "S.",
    "AuthorizedOfficialTitle": "PSYCHOLOGIST",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PHD",
    "AuthorizedOfficialTelephoneNumber": "973-669-3333",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "37LC000043500",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "35S100432500",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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