Provider Demographics
NPI:1962880526
Name:FISHER, PERRY
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:
Last Name:FISHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 E 17TH ST
Mailing Address - Street 2:2ND FLOOR, ROOM 223
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3821
Mailing Address - Country:US
Mailing Address - Phone:212-420-3743
Mailing Address - Fax:
Practice Address - Street 1:353 E 17TH ST
Practice Address - Street 2:2ND FLOOR, ROOM 223
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3821
Practice Address - Country:US
Practice Address - Phone:212-420-3743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293627207RC0000X, 207RI0011X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program