Individual
PETER FIASCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
87TH MEDICAL GROUP, 3458 NEELY ROAD, JB MDL, NJ 08641-5312
(609) 754-9324
Mailing address
3458 NEELY RD, JB MDL, NJ 08641-5312
(609) 754-9324
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS007470L
PA
Other
Enumeration date
04/14/2009
Last updated
06/12/2018
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