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General NPI Number Information
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NPI Number | 1083340210
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Entity Type | Individual
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Provider Name | TRACY S FLEISCHMAN NP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 3376 NIAGARA FALLS BLVD
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-1396
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Country | US
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Telephone | 716-264-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 3275 EVERGREEN DR
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-1501
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Country | US
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Telephone | 716-930-0325
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 309511
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 309511
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License Number State | NY
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