Provider Demographics
NPI:1275667842
Name:NORBERT FLEISIG MD INC
Entity Type:Organization
Organization Name:NORBERT FLEISIG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES S CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:NORBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-521-3292
Mailing Address - Street 1:1 RANDALL SQUARE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904
Mailing Address - Country:US
Mailing Address - Phone:401-521-3292
Mailing Address - Fax:401-521-5424
Practice Address - Street 1:1 RANDALL SQUARE
Practice Address - Street 2:SUITE 304
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904
Practice Address - Country:US
Practice Address - Phone:401-521-3292
Practice Address - Fax:401-521-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI3886208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI5032OtherBLUE CROSS BLUE SHIELD RI
RI1700280OtherUNITED HEALTH CARE
RI5032OtherBLUE CROSS BLUE SHIELD RI