Provider Demographics
NPI:1417434077
Name:PFIZENMAYER, PATRICK D (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:D
Last Name:PFIZENMAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1119 RAINBOW CIR
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-9175
Mailing Address - Country:US
Mailing Address - Phone:856-904-3209
Mailing Address - Fax:
Practice Address - Street 1:1541 FLORIDA AVE STE 100
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4438
Practice Address - Country:US
Practice Address - Phone:209-577-3388
Practice Address - Fax:209-338-0024
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NDPT19648208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program