Healthcare Provider Details

I. General information

NPI: 1669420857
Provider Name (Legal Business Name): ILENE M. FISCHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEIDI S. ROSENBERG M.D.

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 PARK AVE S 13TH FLOOR SUITE 1305
NEW YORK NY
10016-8410
US

IV. Provider business mailing address

419 PARK AVE S 13TH FLOOR SUITE 1305
NEW YORK NY
10016-8410
US

V. Phone/Fax

Practice location:
  • Phone: 212-545-5400
  • Fax: 212-447-1796
Mailing address:
  • Phone: 212-545-5400
  • Fax: 212-447-1796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number18602
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number185602
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: