Provider Demographics
NPI:1003970765
Name:FISHER, JOSEPH E (PSYD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:FISHER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 FRAZER AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1530
Mailing Address - Country:US
Mailing Address - Phone:856-858-0723
Mailing Address - Fax:
Practice Address - Street 1:520 N DELAWARE AVE
Practice Address - Street 2:3D
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-4226
Practice Address - Country:US
Practice Address - Phone:215-923-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008848L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical