Fuentes Funez, Magdiel Lenin
Fuentes Funez, Magdiel Lenin is an individual health care provider with primary practice located at 350 Engle St Fl 5 , Englewood NJ 07631-1808. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Fuentes Funez, Magdiel Lenin can be contacted via phone (201) 894-3636.Contact Information
Primary practice address
350 Engle St Fl 5
Englewood NJ 07631-1808
Phone: (201) 894-3636
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA54487 | California |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 3083 | South Carolina |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 25MP00577200 | New Jersey |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA54487 | California |
Profile Details
NPI number | 1467972612 |
---|---|
LBN Legal business name | Fuentes Funez, Magdiel Lenin |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 20th, 2017 |
Last updated | Apr 8th, 2024 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467972612 | NPPES |
New Jersey | MEDICAID | 0977721 |
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