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NPI Code Detail

MEDICARE: DR. JUDITH DANELLE FISHER MD

MEDICARE: DR. JUDITH DANELLE FISHER MD
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
1102L00000XPsychoanalyst186954NY

General Provider Information

NPI Number : 1265553242
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDITH DANELLE FISHER MD
Provider Business Mailing Address
First Line : 332 BLEECKER ST
Second Line : #F16
City : NEW YORK
State : NY
Zip : 10014-2980
Country : US
Telephone Number : 917-853-6209
Fax Number : 212-691-8661
Provider Business Practice Location Address
First Line : 332 BLEECKER ST
Second Line : #F16
City : NEW YORK
State : NY
Zip : 10014-2980
Country : US
Telephone Number : 917-853-6209
Fax Number : 212-691-8661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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