1558379305 NPI number — EVA FISCHER M.D.

Table of content: EVA FISCHER M.D. (NPI 1558379305)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558379305 NPI number — EVA FISCHER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FISCHER
Provider First Name:
EVA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558379305
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
294 GRANDVIEW AVE
Provider Second Line Business Mailing Address:
ADMINISTRATIVE OFFICE
Provider Business Mailing Address City Name:
MONTEBELLO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10901-2901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-533-4600
Provider Business Mailing Address Fax Number:
845-533-4555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
156 ROUTE 59 STE B1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUFFERN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10901-5014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-517-5000
Provider Business Practice Location Address Fax Number:
845-533-4555
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  173175 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02980H1 . This is a "EMPIRE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3282982 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4563572 . This is a "AETNA TRADITIONAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81714 . This is a "GHI HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 173175 . This is a "HIP OF NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3619985 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0104095 . This is a "GHI" identifier . This identifiers is of the category "OTHER".




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