Healthcare Provider Details

I. General information

NPI: 1548170947
Provider Name (Legal Business Name): JULIA FISHER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 SAINT EDWARDS ST
BROOKLYN NY
11205-3184
US

IV. Provider business mailing address

336 E 86TH ST APT 9H
NEW YORK NY
10028-4617
US

V. Phone/Fax

Practice location:
  • Phone: 718-855-6838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14459472
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: