Provider Demographics
NPI:1700879210
Name:FISHERMAN, BARRY N (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:N
Last Name:FISHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:825 E GATE BLVD
Mailing Address - Street 2:STE 111
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2136
Mailing Address - Country:US
Mailing Address - Phone:516-766-5851
Mailing Address - Fax:
Practice Address - Street 1:400 S OYSTER BAY RD STE 303
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-681-3939
Practice Address - Fax:516-681-0297
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110983207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00377486Medicaid
NY00377486Medicaid
NY292932Medicare ID - Type Unspecified