Provider Demographics
NPI:1689995078
Name:FLEISCHMAN, TATIANA (MD)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:FLEISCHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 OAK ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5316
Mailing Address - Country:US
Mailing Address - Phone:203-275-6666
Mailing Address - Fax:
Practice Address - Street 1:47 OAK ST
Practice Address - Street 2:SUITE 110
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5316
Practice Address - Country:US
Practice Address - Phone:203-275-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-19
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine