Provider Demographics
NPI:1740434513
Name:FISHER, EILEEN W
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:W
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2610
Mailing Address - Country:US
Mailing Address - Phone:718-884-5920
Mailing Address - Fax:718-884-5920
Practice Address - Street 1:5441 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2610
Practice Address - Country:US
Practice Address - Phone:718-884-5920
Practice Address - Fax:718-884-5920
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist