Provider Demographics
NPI:1306265889
Name:FISCHL, ADRIAN M (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:M
Last Name:FISCHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:631-444-2968
Mailing Address - Fax:631-444-2907
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY SUNY STONY BROOK
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8480
Practice Address - Country:US
Practice Address - Phone:631-444-2968
Practice Address - Fax:631-444-2907
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY297254-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program