Basic Information
| Provider Information | |||||||||
| NPI: | 1427097534 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FISCHGRUND | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | GARY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 56 CORNELL DR | ||||||||
| Address2: | |||||||||
| City: | LIVINGSTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070395519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739924930 | ||||||||
| FaxNumber: | 9736962260 | ||||||||
| Practice Location | |||||||||
| Address1: | 61 BEAVERBROOK RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | LINCOLN PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070351748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736966687 | ||||||||
| FaxNumber: | 9736962260 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 07/06/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MA036275 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.