Basic Information
Provider Information
NPI: 1376529966
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINGERMAN
FirstName: JARAD
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 DIAMOND HILL RD
Address2:  
City: BERKELEY HEIGHTS
State: NJ
PostalCode: 079222104
CountryCode: US
TelephoneNumber: 9082734300
FaxNumber:  
Practice Location
Address1: 2 PRINCESS RD
Address2: SUITE J
City: LAWRENCEVILLE
State: NJ
PostalCode: 086482320
CountryCode: US
TelephoneNumber: 6098951991
FaxNumber: 6098956996
Other Information
ProviderEnumerationDate: 12/16/2005
LastUpdateDate: 03/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000X25MB07419700NJY Allopathic & Osteopathic PhysiciansUrology 

ID Information
IDTypeStateIssuerDescription
006142505NJ MEDICAID


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