Provider Demographics
NPI:1821081878
Name:FISCHER, AVI (MD)
Entity Type:Individual
Prefix:DR
First Name:AVI
Middle Name:
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:MOUNT SINAI MEDICAL CENTER
Mailing Address - Street 2:5 EAST 98TH STREET, 3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-7272
Mailing Address - Fax:212-534-2776
Practice Address - Street 1:MOUNT SINAI MEDICAL CENTER
Practice Address - Street 2:5 EAST 98TH STREET, 3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-7272
Practice Address - Fax:212-534-2776
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY204909-1207RC0000X
NY204909207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02414771Medicaid
NY5457E3Medicare ID - Type Unspecified
NY02414771Medicaid