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General NPI Number Information
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NPI Number | 1316019391
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Entity Type | Individual
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Provider Name | DANIEL I. FISCHMAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 14-A JAYNE AVENUE
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City | PATCHOGUE
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State | NY
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Zip | 11772
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Country | US
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Telephone | 631-475-0222
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Fax | 631-475-0586
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Provider Business Mailing Address
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Address Line | 14A JAYNE AVE
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City | PATCHOGUE
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State | NY
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Zip | 11772-2804
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Country | US
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Telephone | 631-475-0222
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Fax | 631-475-0586
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T-005108-1
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License Number State | NY
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