Provider Demographics
NPI:1760772776
Name:FLEISHER, MICHAEL LACK (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LACK
Last Name:FLEISHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:275 CENTRAL PARK W
Mailing Address - Street 2:APT 15F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3015
Mailing Address - Country:US
Mailing Address - Phone:212-581-2310
Mailing Address - Fax:212-877-7895
Practice Address - Street 1:65 W 55TH ST
Practice Address - Street 2:SUITE 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4913
Practice Address - Country:US
Practice Address - Phone:212-581-2310
Practice Address - Fax:212-877-7895
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
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Provider Licenses
StateLicense IDTaxonomies
NY9874912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry