Provider Demographics
NPI:1386976314
Name:FISHER, CLAUDINE
Entity type:Individual
Prefix:MS
First Name:CLAUDINE
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 BEACH 56TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1720
Mailing Address - Country:US
Mailing Address - Phone:929-366-3787
Mailing Address - Fax:
Practice Address - Street 1:334 BEACH 56TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1720
Practice Address - Country:US
Practice Address - Phone:929-366-3787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292526-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse