1558379305 NPI number — EVA FISCHER M.D.

Table of Contents

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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