Provider Demographics
NPI:1992880744
Name:FLEISCHMAN, AMY D (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:D
Last Name:FLEISCHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:119 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1848
Mailing Address - Country:US
Mailing Address - Phone:617-290-7219
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-3634
Practice Address - Fax:617-730-0194
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211175208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0135330Medicaid
MA0135330Medicaid