Provider Demographics
NPI:1629056627
Name:FISHER, CHANDRA M (DO)
Entity Type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:M
Last Name:FISHER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:425 ESSJAY RD
Mailing Address - Street 2:STE 170
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5782
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:325 ESSJAY RD
Practice Address - Street 2:SUITE 110
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8243
Practice Address - Country:US
Practice Address - Phone:716-630-1047
Practice Address - Fax:716-250-5921
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2021-12-13
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Provider Licenses
StateLicense IDTaxonomies
NY229869-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161000580OtherNORTH AMERICAN PREFERRED
NY161000580OtherEMPIRE
NY00026856201OtherUNIVERA
NY0112620OtherIHA
NYP00142380OtherRR MEDICARE
NY000527765001OtherHEALTH NOW
NY1054402Medicaid
NY000527765001OtherHEALTH NOW
NYP00142380OtherRR MEDICARE