Provider Demographics
NPI:1912784604
Name:FISHER, RENE RECHIS (IBCLC)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:RECHIS
Last Name:FISHER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 HIGHLAND AVE EXT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4451
Mailing Address - Country:US
Mailing Address - Phone:845-800-7275
Mailing Address - Fax:
Practice Address - Street 1:361 HIGHLAND AVE EXT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4451
Practice Address - Country:US
Practice Address - Phone:845-800-7275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN