Healthcare Provider Details

I. General information

NPI: 1902068802
Provider Name (Legal Business Name): FISHKILL MEDICAL & ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 MIDDLEBUSH RD SUITE 202
WAPPINGERS FALLS NY
12590-4098
US

IV. Provider business mailing address

66 MIDDLEBUSH RD SUITE 202
WAPPINGERS FALLS NY
12590-4098
US

V. Phone/Fax

Practice location:
  • Phone: 845-896-5900
  • Fax: 845-896-4545
Mailing address:
  • Phone: 845-896-5900
  • Fax: 845-896-4545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number147940
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: SURESH CHANDANI
Title or Position: MD
Credential:
Phone: 845-896-5900