Provider Demographics
NPI:1528568698
Name:FRITZKY, JOSEPH J (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:J
Last Name:FRITZKY
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:COLLEGE PLAZA PEDIATRICS
Mailing Address - Street 2:165 ROUTE 10 EAST, SUITE 203
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869
Mailing Address - Country:US
Mailing Address - Phone:973-659-9991
Mailing Address - Fax:973-659-9632
Practice Address - Street 1:COLLEGE PLAZA PEDIATRICS
Practice Address - Street 2:165 ROUTE 10 EAST, SUITE 203
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869
Practice Address - Country:US
Practice Address - Phone:973-659-9991
Practice Address - Fax:973-659-9632
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA10878300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program