MEDICARE: PAUL D FISHER 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
1	2085P0229X	Pediatric Radiology Physician	DR.0071499	CO
2	2085P0229X	Pediatric Radiology Physician	ME82697	FL
3	2085P0229X	Pediatric Radiology Physician	315370	NY
4	2085P0229X	Pediatric Radiology Physician	036-166427	IL

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	:	1619932894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL D FISHER MD

Provider Business Mailing Address
First Line	:	1 GUSTAVE L LEVY PL
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6504
Country	:	US
Telephone Number	:	212-241-8333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1468 MADISON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6508
Country	:	US
Telephone Number	:	212-241-9870
Fax Number	:

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	04/06/2026

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Directions to “ PAUL D FISHER MD” Practice Location

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