Provider Demographics
NPI:1679839450
Name:FISHMAN, ANDREW I (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:I
Last Name:FISHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9229 QUEENS BLVD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1072
Mailing Address - Country:US
Mailing Address - Phone:718-606-6912
Mailing Address - Fax:718-606-6914
Practice Address - Street 1:9229 QUEENS BLVD
Practice Address - Street 2:SUITE 2B
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1072
Practice Address - Country:US
Practice Address - Phone:718-606-6912
Practice Address - Fax:718-606-6914
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2014-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY248604208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology