Provider Demographics
NPI:1083607865
Name:BISSINGER, CRAIG L (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:L
Last Name:BISSINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHERRY HILL RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1113
Mailing Address - Country:US
Mailing Address - Phone:973-335-8500
Mailing Address - Fax:973-335-8429
Practice Address - Street 1:50 CHERRY HILL RD
Practice Address - Street 2:SUITE 303
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1113
Practice Address - Country:US
Practice Address - Phone:973-335-8500
Practice Address - Fax:973-335-8429
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ50990207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C48568Medicare UPIN
459569Medicare ID - Type Unspecified