Organization
MARK S. SOFAIR-FISCH, PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S. SOFAIR-FISCH PHD (PSYCHOLOGIST)
(973) 669-3333
Entity
Organization
Contact information
Practice address
2737 PRINCETON PIKE, LAWRENCEVILLE, NJ 08648-3220
(609) 883-2577
(609) 883-2092
Mailing address
5 ELLIS ST, WEST ORANGE, NJ 07052-3612
(973) 669-3333
(973) 669-9675
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC000043500
NJ
103TC0700X
Clinical Psychologist
Primary
35S100432500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
469819000
MAGELLAN
NJ
Enumeration date
03/11/2007
Last updated
05/13/2009
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