Fog, Denise

Fog, Denise is an individual health care provider with primary practice located at 748 Kings Hwy , Woodbury NJ 08096-3157. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Fog, Denise can be contacted via phone (856) 848-4998.

Contact Information

Primary practice address
748 Kings Hwy Woodbury NJ 08096-3157
Fax: (856) 848-9288
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MB077069 New Jersey

Profile Details

NPI number 1548268733
LBN Legal business name Fog, Denise
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Jan 22nd, 2015 - about 9 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 1548268733 NPPES
New Jersey MEDICAID 0015385

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