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General NPI Number Information
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NPI Number | 1609942325
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Entity Type | Individual
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Provider Name | JOSEPH FISCH MD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 747 MONTAUK HGWY
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City | WEST ISLIP
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State | NY
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Zip | 11795
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Country | US
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Telephone | 631-587-5444
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Fax | 631-587-4938
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Provider Business Mailing Address
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Address Line | 532 BROADHOLLOW RD SUITE 142
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City | MELVILLE
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State | NY
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Zip | 11747-3672
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Country | US
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Telephone | 516-931-0041
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 181787
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License Number State | NY
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