Provider Demographics
NPI:1508392143
Name:FISHER, EMMA ROSE
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:ROSE
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 9TH ST APT E4C
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2180
Mailing Address - Country:US
Mailing Address - Phone:516-780-3753
Mailing Address - Fax:
Practice Address - Street 1:216 E 120TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3001
Practice Address - Country:US
Practice Address - Phone:212-860-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist