Provider Demographics
NPI:1265057715
Name:FISCHTEIN, DANIT (MD)
Entity type:Individual
Prefix:
First Name:DANIT
Middle Name:
Last Name:FISCHTEIN
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 1:8350 VIA SERENA
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2235
Mailing Address - Country:US
Mailing Address - Phone:561-945-0092
Mailing Address - Fax:
Practice Address - Street 1:8350 VIA SERENA
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2235
Practice Address - Country:US
Practice Address - Phone:561-945-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101269169207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine