Provider Demographics
NPI:1992147128
Name:BARRY FISHER M.D. P.C.
Entity type:Organization
Organization Name:BARRY FISHER M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:GERSHON
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-466-6160
Mailing Address - Street 1:560 NORTHERN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5100
Mailing Address - Country:US
Mailing Address - Phone:516-466-6160
Mailing Address - Fax:516-466-7814
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5100
Practice Address - Country:US
Practice Address - Phone:516-466-6160
Practice Address - Fax:516-466-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131062-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY58A081Medicare UPIN