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Individual

JORDAN FERSEL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
138 W 56TH ST, BAYONNE, NJ 07002-2210
(201) 243-1031
Mailing address
138 W 56TH ST, BAYONNE, NJ 07002-2210
(201) 243-1031

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MA049662
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0952401
NJ
Enumeration date
11/02/2005
Last updated
07/08/2007
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