MEDICARE: DR. JAY A FLEISCHMAN M.D.

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	207W00000X	Ophthalmology Physician	175307-1	NY
2	207W00000X	Ophthalmology Physician	038615	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497750673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY A FLEISCHMAN M.D.

Provider Business Mailing Address
First Line	:	1200 WATERS PL
Second Line	:	SUITE M104
City	:	BRONX
State	:	NY
Zip	:	10461-2728
Country	:	US
Telephone Number	:	914-315-5111
Fax Number	:	718-918-0442

Provider Business Practice Location Address
First Line	:	1200 WATERS PL
Second Line	:	SUITE M104
City	:	BRONX
State	:	NY
Zip	:	10461-2728
Country	:	US
Telephone Number	:	914-315-5111
Fax Number	:	718-918-0442

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	10/28/2010

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