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General NPI Number Information
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NPI Number | 1205582541
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Entity Type | Organization
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Legal Business Name | FISH PSYCHIATRIC PRACTICE LLC
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 22 JUDGES HILL DR
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City | NORWELL
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State | MA
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Zip | 02061-1041
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Country | US
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Telephone | 857-330-2716
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Fax | 904-637-1524
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Provider Business Mailing Address
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Address Line | 759 CHIEF JUSTICE CUSHING HWY STE 267
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City | COHASSET
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State | MA
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Zip | 02025-2115
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Country | US
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Telephone | 857-330-2716
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Fax | 904-637-1524
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID W. FISH
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Credential | DO
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Telephone | 857-330-2716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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