Nikita Fonarev

NPI 1811661242 · on the registry since 2021

Practice

Address: 20 Randolph Pl Ste A
West Orange, NJ 07052
Phone: (347) 668-0107
Organisation at this address: Anycolor Wellness, Llc
Inferred from a shared address, not stated in the registry.

Additional practice sites

830 Morris Tpke Ste 405, Short Hills, NJ
310 Cedar Ln Ste 3b, Teaneck, NJ

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: NJ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-03-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey