Provider Demographics
NPI:1487640157
Name:FISCHER, MITCHELL (DO)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:
Last Name:FISCHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EAST MAIN STREET
Mailing Address - Street 2:EMERGENCY DEPARTMENT NORTHERN WESTCHESTER HOSPITAL
Mailing Address - City:MT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-666-1200
Mailing Address - Fax:914-666-1965
Practice Address - Street 1:400 EAST MAIN STREET
Practice Address - Street 2:EMERGENCY DEPARTMENT NORTHERN WESTCHESTER HOSPITAL
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-666-1244
Practice Address - Fax:914-666-1931
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY183313207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1534785OtherUNITED HEALTHCARE
5C6149OtherHEALTHNET
7895711OtherAETNA PPO
06023000074OtherFIDELIS
NJ0173011Medicaid
0495Q1OtherBCBS
P2806750OtherOXFORD
10015062OtherCAPITAL DISTR
1092584OtherAETNA HMO
2139650OtherCOVENTRY
4147730OtherMVP
NJ0173011Medicaid
2139650OtherCOVENTRY