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NPI Code Detail

MEDICARE: REBECCA FISK

MEDICARE: REBECCA FISK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker087870NY

General Provider Information

NPI Number : 1003490160
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA FISK
Provider Business Mailing Address
First Line : 667 STONELEIGH AVE STE 202
Second Line :
City : CARMEL
State : NY
Zip : 10512-2455
Country : US
Telephone Number : 845-279-5908
Fax Number :
Provider Business Practice Location Address
First Line : 1940 COMMERCE ST STE 309
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-4449
Country : US
Telephone Number : 914-245-0437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2021
Last Update Date : 05/05/2021

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Directions to “ REBECCA FISK ” Practice Location

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