Provider Demographics
NPI:1780802686
Name:FLEISCHMANN, JAMES CONRAD (MS, CRC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CONRAD
Last Name:FLEISCHMANN
Suffix:
Gender:M
Credentials:MS, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:616 STANTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1730
Mailing Address - Country:US
Mailing Address - Phone:516-410-3228
Mailing Address - Fax:
Practice Address - Street 1:79 MIDDLEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-221-6011
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health