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NPI Code Detail

MEDICARE: MITCHELL EVAN FISHLER LMSW

MEDICARE:   MITCHELL EVAN FISHLER  LMSW
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
1104100000XSocial Worker069015NY

General Provider Information

NPI Number : 1912914672
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCHELL EVAN FISHLER LMSW
Provider Business Mailing Address
First Line : 22 LAKEVIEW DRIVE
Second Line :
City : KIAMESHA LAKE
State : NY
Zip : 12751
Country : US
Telephone Number : 845-791-5926
Fax Number :
Provider Business Practice Location Address
First Line : 4551 RTE 55
Second Line :
City : SWAN LAKE
State : NY
Zip : 12783
Country : US
Telephone Number : 885-292-6880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 07/08/2007

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Directions to “ MITCHELL EVAN FISHLER LMSW” Practice Location

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