Provider Demographics
NPI:1376636852
Name:FIALKOFF, CHERYL N (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:N
Last Name:FIALKOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 SOUTH STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-267-0300
Mailing Address - Fax:973-695-1480
Practice Address - Street 1:182 SOUTH STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-267-0300
Practice Address - Fax:973-695-1480
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05486100207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ621555BV6Medicare PIN
NJE99517Medicare UPIN