Provider Demographics
NPI:1427098631
Name:FOX, DAVID BERNARD (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BERNARD
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3006
Mailing Address - Country:US
Mailing Address - Phone:732-219-0333
Mailing Address - Fax:732-219-6526
Practice Address - Street 1:776 SHREWSBURY AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3006
Practice Address - Country:US
Practice Address - Phone:732-219-0333
Practice Address - Fax:732-219-6526
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05643100208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
0674631OtherCIGNA
1884954OtherUNITED HEALTHCARE
223387480002OtherQUALCARE
5770149OtherAETNA
223387480002OtherSBSHC
NJF12448OtherHEALTHNET
P1027893OtherOXFORD
2598116OtherGHI
223387480002OtherQUALCARE
NJ795822Medicare PIN