Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 274464 | NY |
N | 208000000X | Pediatrician | 274464 | NY |
NPI | 1003115668 |
---|---|
Provider Name | Dr. Diana Trevas Fleisher |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016-6402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2011 |
Last Update Date | 29/12/2021 |