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Individual

MATIS A. FERMAGLICH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
865 TEANECK RD, TEANECK, NJ 07666-4513
(201) 837-0606
(201) 837-1952
Mailing address
15-01 BROADWAY, RT 4 WEST, SUITES 1 & 3, FAIR LAWN, NJ 07410
(201) 791-4544
(201) 791-6585

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA02477500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1409506
NJ
Enumeration date
03/23/2006
Last updated
07/08/2007
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