Provider Demographics
NPI:1750659116
Name:DR. JEFFREY M. FITCH
Entity Type:Organization
Organization Name:DR. JEFFREY M. FITCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:FITCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-449-8330
Mailing Address - Street 1:2022 STATE ROUTE 71
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2291
Mailing Address - Country:US
Mailing Address - Phone:732-449-8330
Mailing Address - Fax:
Practice Address - Street 1:2022 STATE ROUTE 71
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2291
Practice Address - Country:US
Practice Address - Phone:732-449-8330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ452459Medicare PIN