Provider Demographics
NPI:1649377730
Name:S MICHAEL FUHRMAN DO PLLC
Entity type:Organization
Organization Name:S MICHAEL FUHRMAN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:518-439-9911
Mailing Address - Street 1:363 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1903
Mailing Address - Country:US
Mailing Address - Phone:518-439-9911
Mailing Address - Fax:518-439-7726
Practice Address - Street 1:363 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1903
Practice Address - Country:US
Practice Address - Phone:518-439-9911
Practice Address - Fax:518-439-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169532-1207PE0004X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY080176396OtherRAILROAD MEDICARE
NYAA1284Medicare ID - Type Unspecified