Provider Demographics
NPI:1376713131
Name:FISCHER, RENEE A (PT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:A
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 KING GEORGE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2816
Mailing Address - Country:US
Mailing Address - Phone:973-479-1139
Mailing Address - Fax:
Practice Address - Street 1:413 KING GEORGE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2816
Practice Address - Country:US
Practice Address - Phone:973-479-1139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00655200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist