Provider Demographics
NPI:1720181720
Name:SCOTT A. FLEISCHER, M.D., P.C.
Entity Type:Organization
Organization Name:SCOTT A. FLEISCHER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-793-4546
Mailing Address - Street 1:455 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3403
Mailing Address - Country:US
Mailing Address - Phone:215-793-4546
Mailing Address - Fax:215-793-9007
Practice Address - Street 1:455 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3403
Practice Address - Country:US
Practice Address - Phone:215-793-4546
Practice Address - Fax:215-793-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA575782Medicare ID - Type UnspecifiedGRP MEDICARE NUMBER