Provider Demographics
NPI:1215950712
Name:FISCHLER, ARNOLD J (DMD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:J
Last Name:FISCHLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24202 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1996
Mailing Address - Country:US
Mailing Address - Phone:718-631-3030
Mailing Address - Fax:718-279-0113
Practice Address - Street 1:24202 61ST AVE
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-1996
Practice Address - Country:US
Practice Address - Phone:718-631-3030
Practice Address - Fax:718-279-0113
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00973804Medicaid
NY02339040Medicaid