MEDICARE: SHULEM FISHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	004668	NY

General Provider Information

NPI Number	:	1285596932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHULEM FISHER

Provider Business Mailing Address
First Line	:	4901 14TH AVE APT 2G
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3138
Country	:	US
Telephone Number	:	917-474-2241
Fax Number	:	917-474-2241

Provider Business Practice Location Address
First Line	:	4901 14TH AVE APT 2G
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3138
Country	:	US
Telephone Number	:	917-474-2241
Fax Number	:	917-474-2241

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/18/2025

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Directions to “ SHULEM FISHER ” Practice Location

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