Healthcare Provider Details

I. General information

NPI: 1730371246
Provider Name (Legal Business Name): CHERYL MELISSA FISCHER RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

30 W 96TH ST APT 3E
NEW YORK NY
10025-6555
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-2153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number381825
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: