Provider Demographics
NPI:1922155985
Name:FISHER, HOPE (MD)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:FISHER
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 1:8268 164TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1121
Mailing Address - Country:US
Mailing Address - Phone:718-883-3225
Mailing Address - Fax:718-883-6193
Practice Address - Street 1:79-01BROADWAY
Practice Address - Street 2:MANAGED CARE D1-04
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11973
Practice Address - Country:US
Practice Address - Phone:718-334-1921
Practice Address - Fax:718-334-3432
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225511207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY00330231Medicare ID - Type Unspecified