NPI 1003146994

Marvin Wisch PA

Organisation Family Medicine Physician Fair Lawn, NJ

Practice location

Address: 28-09 Fair Lawn Ave, Fair Lawn, NJ 07410-3410
Phone: (201) 796-3171
Fax: (201) 796-8022

Authorised official

Name: Marvin Wisch
Title: Owner
Phone: (201) 796-3171

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence MB14606 (NJ)

Other Family Medicine providers in New Jersey →

Registry record

NPI: 1003146994
Entity type: Organization
NPI issued: 28 Dec 2009
Record last updated: 28 Dec 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.