Healthcare Provider Details

I. General information

NPI: 1760425227
Provider Name (Legal Business Name): ARTHUR HERBERT FISHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 LAUREL DR
MASSAPEQUA PARK NY
11762-3908
US

IV. Provider business mailing address

66 LAUREL DR
MASSAPEQUA PARK NY
11762-3908
US

V. Phone/Fax

Practice location:
  • Phone: 516-972-9652
  • Fax: 999-999-9999
Mailing address:
  • Phone: 516-972-9652
  • Fax: 999-999-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number135866
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: