Provider Demographics
NPI:1619997749
Name:FISCHER, JOEL M (MD)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:M
Last Name:FISCHER
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 1:72 W END AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1824
Mailing Address - Country:US
Mailing Address - Phone:908-927-0300
Mailing Address - Fax:908-707-4988
Practice Address - Street 1:72 W END AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1824
Practice Address - Country:US
Practice Address - Phone:908-927-0300
Practice Address - Fax:908-707-4988
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ58017208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5240701Medicaid
NJ5240701Medicaid
NJE94812Medicare UPIN