Provider Demographics
NPI:1932319514
Name:DRS. E. & D. FISCHMAN, PA
Entity Type:Organization
Organization Name:DRS. E. & D. FISCHMAN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:FISCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-575-2266
Mailing Address - Street 1:901 W INDIANTOWN RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6811
Mailing Address - Country:US
Mailing Address - Phone:561-575-2266
Mailing Address - Fax:561-745-8510
Practice Address - Street 1:901 W INDIANTOWN RD
Practice Address - Street 2:SUITE 15
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6811
Practice Address - Country:US
Practice Address - Phone:561-575-2266
Practice Address - Fax:561-745-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL98695Medicare ID - Type Unspecified
FL6713660001Medicare NSC