Fuentes Funez, Magdiel Lenin

Fuentes Funez, Magdiel Lenin is an individual health care provider with primary practice located at 350 Engle St Fl 5 , Englewood NJ 07631-1808. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Fuentes Funez, Magdiel Lenin can be contacted via phone (201) 894-3636.

Contact Information

Primary practice address
350 Engle St Fl 5 Englewood NJ 07631-1808
Phone: (201) 894-3636
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA54487 California
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 3083 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 25MP00577200 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA54487 California

Profile Details

NPI number 1467972612
LBN Legal business name Fuentes Funez, Magdiel Lenin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2017
Last updated Apr 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467972612 NPPES
New Jersey MEDICAID 0977721

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