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NPI Code Detail

MEDICARE: SHELBY FLEISHER MD

MEDICARE: SHELBY FLEISHER MD
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
1208000000XPediatrics Physician342182-01NY

General Provider Information

NPI Number : 1366145955
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY FLEISHER MD
Provider Business Mailing Address
First Line : 26901 76TH AVE STE C-028
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-1433
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26901 76TH AVE STE C-028
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-1433
Country : US
Telephone Number : 718-470-3204
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2023
Last Update Date : 06/08/2026

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