Provider Demographics
NPI:1558600999
Name:FRISCHEISEN, FELIX ALEJANDRO (MT)
Entity Type:Individual
Prefix:MR
First Name:FELIX
Middle Name:ALEJANDRO
Last Name:FRISCHEISEN
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-2271
Mailing Address - Country:US
Mailing Address - Phone:973-901-4798
Mailing Address - Fax:
Practice Address - Street 1:856 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3211
Practice Address - Country:US
Practice Address - Phone:201-428-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00406800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist