Healthcare Provider Details

I. General information

NPI: 1831518638
Provider Name (Legal Business Name): ALYSSA FISCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

68 WILLOW TREE RD
MONSEY NY
10952-1123
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-4570
  • Fax:
Mailing address:
  • Phone: 914-261-9575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number042.0014149
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: