Provider Demographics
NPI:1194954842
Name:FICHTER, JENNIFER ENID (DPM)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ENID
Last Name:FICHTER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-2538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:289 PLEASANT ST
Practice Address - Street 2:STE 202
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-646-7720
Practice Address - Fax:508-646-7721
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00313700213E00000X
PASC006114213E00000X
MA2403213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ245952MNWMedicare PIN
PA244595MNAMedicare UPIN
NJ244595MNCMedicare PIN