Provider Demographics
NPI:1164517918
Name:FINE, PAUL LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:LEONARD
Last Name:FINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2 FRANKLIN PL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5305
Mailing Address - Country:US
Mailing Address - Phone:973-267-7673
Mailing Address - Fax:973-267-3270
Practice Address - Street 1:2 FRANKLIN PL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5305
Practice Address - Country:US
Practice Address - Phone:973-267-7673
Practice Address - Fax:973-267-3270
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04421200207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ142240502Medicaid
NJ142240502Medicaid
NJC58431Medicare UPIN