Provider Demographics
NPI:1275541021
Name:FLEISCHER, LEE S (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:S
Last Name:FLEISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CROSFIELD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2222
Mailing Address - Country:US
Mailing Address - Phone:845-535-3362
Mailing Address - Fax:845-535-3368
Practice Address - Street 1:1 CROSFIELD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2222
Practice Address - Country:US
Practice Address - Phone:845-535-3362
Practice Address - Fax:845-535-3368
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175057208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
14184OtherGHI HMO
35L751OtherEMPIRE BLUE CROSS
0101614OtherGHI
0119191OtherAETNA HMO
175057OtherHIP OF NY
0D3803OtherHEALTHNET NE
4414421OtherAETNA TRADITIONAL
NY01366292Medicaid
RS366OtherOXFORD
0D3803OtherHEALTHNET NE
RS366OtherOXFORD