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General NPI Number Information
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NPI Number | 1053961896
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Entity Type | Organization
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Legal Business Name | GENERAL SURGERY CONSULTANT PC
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 271 DOUGHTY BLVD
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City | INWOOD
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State | NY
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Zip | 11096-2135
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Country | US
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Telephone | 516-253-6811
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Fax |
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Provider Business Mailing Address
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Address Line | 12 BAYVIEW AVE UNIT 128
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City | LAWRENCE
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State | NY
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Zip | 11559-4007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CHAIM FISHFELD
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Credential |
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Telephone | 917-699-1416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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