Fernandes, Jaxon James

Fernandes, Jaxon James is an individual health care provider with primary practice located at 1 Clara Maass Dr , Belleville NJ 07109-3550. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fernandes, Jaxon James can be contacted via phone (973) 450-2000.

Contact Information

Primary practice address
1 Clara Maass Dr Belleville NJ 07109-3550
Phone: (973) 450-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA08153000 New Jersey

Profile Details

NPI number 1073675740
LBN Legal business name Fernandes, Jaxon James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2006
Last updated Oct 24th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073675740 NPPES
New Jersey MEDICAID 0125237
New Jersey Other P00399307

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