Healthcare Provider Details

I. General information

NPI: 1780627539
Provider Name (Legal Business Name): MARIAN FLEISCHER,M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 N BROADWAY #206
YONKERS NY
10701-1304
US

IV. Provider business mailing address

944 N BROADWAY #206
YONKERS NY
10701-1304
US

V. Phone/Fax

Practice location:
  • Phone: 914-963-1400
  • Fax: 914-722-6102
Mailing address:
  • Phone: 914-963-1400
  • Fax: 914-722-6102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number137530
License Number StateNY

VIII. Authorized Official

Name: DR. MARIAN FLEISCHER
Title or Position: SOLE PROPRIETOR
Credential: M.D.
Phone: 914-963-1400