Michael J Fidanzato, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MA54952 Issued in NJ

Practice address

601 Ewing St
Suite C7
Princeton, NJ 08540-2757

Phone

(609) 921-7620

Fax

(609) 921-0869

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881750834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ADAMS DR",
            "city": "BELLE MEAD",
            "state": "NJ",
            "postal_code": "085024615",
            "telephone_number": "609-921-7620",
            "fax_number": "609-921-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EWING ST",
            "address_2": "SUITE C7",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402757",
            "telephone_number": "609-921-7620",
            "fax_number": "609-921-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDANZATO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA54952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa Fernandez
• Ricardo Fernandez, MD
• Chandani D Fernando, MD
• Feroza Hossain, Inc
• Kevin Francis Ferry, LCSW, LCADC
• Ryan Field, PA-C
• David Eldredge Fiero, D.M.D.
• Jocelyn Fierstien, PSY.D.
• Hannah Fingerhut, OTR/L
• Tobe M Fisch, M.D.

• Gastroenterology Physician in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.