Provider Demographics
NPI:1780627539
Name:MARIAN FLEISCHER,M.D.
Entity type:Organization
Organization Name:MARIAN FLEISCHER,M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-963-1400
Mailing Address - Street 1:944 N BROADWAY
Mailing Address - Street 2:#206
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1304
Mailing Address - Country:US
Mailing Address - Phone:914-963-1400
Mailing Address - Fax:914-722-6102
Practice Address - Street 1:944 N BROADWAY
Practice Address - Street 2:#206
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1304
Practice Address - Country:US
Practice Address - Phone:914-963-1400
Practice Address - Fax:914-722-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137530208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB19141Medicare UPIN