Individual
DR. BRUCE TISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
177 N DEAN ST, SUITE 208, ENGLEWOOD, NJ 07631-2533
(201) 569-0200
(201) 569-8287
Mailing address
177 N DEAN ST, SUITE 208, ENGLEWOOD, NJ 07631-2533
(201) 569-0200
(201) 569-8287
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MA31321
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4719301
—
NJ
Enumeration date
08/04/2006
Last updated
04/28/2008
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