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Individual

MR. ERICK JAMES FISCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS OT

Contact information

Practice address
16 AZALEA DR, EDISON, NJ 08820-4101
(732) 406-4644
Mailing address
16 AZALEA DR, EDISON, NJ 08820-4101
(732) 406-4644

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
010000875
DC
225X00000X
Occupational Therapist
115286
TX
225X00000X
Occupational Therapist
Primary
13457
CA
225X00000X
Occupational Therapist
OC015226
PA

Other

Enumeration date
06/12/2013
Last updated
10/16/2017
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