Provider Demographics
NPI:1992772966
Name:FISHER, AKINOLA (MD)
Entity type:Individual
Prefix:DR
First Name:AKINOLA
Middle Name:
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:234 EUGENIO MARIA DE HOSTOS BLVD, LINCOLN MEDICAL CENTE
Mailing Address - Street 2:ATTEN: AMBULATORY CARE ADMINISTRATION 2ND FLOOR ANNEX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-579-5640
Mailing Address - Fax:718-579-4799
Practice Address - Street 1:234 EUGENIO MARIA DE HOSTOS BLVD, LINCOLN MEDICAL CENTE
Practice Address - Street 2:ATTEN: AMBULATORY CARE ADMINISTRATION 2ND FLOOR ANNEX
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-5640
Practice Address - Fax:718-579-4799
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH09532Medicare UPIN