Mary Magnusen Fahsbender, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB56521 Issued in NJ

Practice address

5678 Berkshire Valley Rd
Oak Ridge, NJ 07438-9370

Phone

(973) 697-0200

Fax

(973) 383-0448

NPI assigned

Mar 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Mary L Magnusen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1659340255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5678 BERKSHIRE VALLEY RD",
            "city": "OAK RIDGE",
            "state": "NJ",
            "postal_code": "074389370",
            "telephone_number": "973-697-0200",
            "fax_number": "973-383-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5678 BERKSHIRE VALLEY RD",
            "city": "OAK RIDGE",
            "state": "NJ",
            "postal_code": "074389370",
            "telephone_number": "973-697-0200",
            "fax_number": "973-383-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHSBENDER",
        "first_name": "MARY",
        "middle_name": "MAGNUSEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB56521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4583400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MAGNUSEN",
            "middle_name": "L",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Medicine Physician in Oak Ridge, NJ
• Providers in Oak Ridge, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.