MARVIN WISCH PA NPI 1003146994

NPI Information

  • NPI: 1003146994
  • Provider Name: MARVIN WISCH PA
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 28-09 FAIR LAWN AVE
    FAIR LAWN, NJ
    ZIP 07410
  • Phone: (201) 796-3171

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NPI Details

MARVIN WISCH PA is a family medicine in Fair Lawn, NJ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MARVIN WISCH PA NPI is 1003146994. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

28-09 FAIR LAWN AVE
FAIR LAWN, NJ
ZIP 07410-410
Phone: (201) 796-3171
Fax: (201) 796-8022

The provider's authorized official is Marvin Wisch .
The authorized official title is Owner and has the following contact phone number (201) 796-3171.

The enumeration date for this NPI number is 12/28/2009 and was last updated on 12/28/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineMB14606NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14697707MEDICAIDNEW JERSEY
2444378MEDICARE PINNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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