Healthcare Provider Details

I. General information

NPI: 1184950107
Provider Name (Legal Business Name): DINA MARGARET FISHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 LINWOOD AVE
WILLIAMSVILLE NY
14221-6673
US

IV. Provider business mailing address

111 EDEN ST
BUFFALO NY
14220-2667
US

V. Phone/Fax

Practice location:
  • Phone: 716-626-9016
  • Fax:
Mailing address:
  • Phone: 716-931-2995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF402566
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number407141-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: