Individual
MARY ANN FISCELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
20 WILSEY SQUARE, RIDGEWOOD, NJ 07450
(201) 444-6656
(201) 444-5279
Mailing address
20 WILSEY SQUARE, RIDGEWOOD, NJ 07450
(201) 444-6656
(201) 444-5279
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00301800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1107607
—
NJ
Enumeration date
03/02/2007
Last updated
07/08/2007
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