Individual
STEPHEN HISCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
485 RIVER AVE, LAKEWOOD, NJ 08701-4720
(732) 364-7100
Mailing address
1079 MONTAUK DR, FORKED RIVER, NJ 08731-2004
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00139900
NJ
Other
Enumeration date
10/14/2007
Last updated
10/14/2007
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