Provider Demographics
NPI:1265553242
Name:FISHER, JUDITH DANELLE (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:DANELLE
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:332 BLEECKER ST
Mailing Address - Street 2:#F16
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2980
Mailing Address - Country:US
Mailing Address - Phone:917-853-6209
Mailing Address - Fax:212-691-8661
Practice Address - Street 1:332 BLEECKER ST
Practice Address - Street 2:#F16
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2980
Practice Address - Country:US
Practice Address - Phone:917-853-6209
Practice Address - Fax:212-691-8661
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY186954102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst