MEDICARE: DR. NELLI FISHER 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	207V00000X	Obstetrics & Gynecology Physician	243809-1	NY

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	:	1568674919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NELLI FISHER M.D.

Provider Business Mailing Address
First Line	:	5014 FORT HAMILTON PKWY
Second Line	:	APT 6F
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3324
Country	:	US
Telephone Number	:	718-283-7979
Fax Number	:

Provider Business Practice Location Address
First Line	:	5014 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3324
Country	:	US
Telephone Number	:	718-283-7979
Fax Number	:

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

Provider Enumeration Date	:	05/05/2007
Last Update Date	:	03/21/2014

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