Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 022760 | NY |
NPI | 1710971536 |
---|---|
Provider Name | Dr. Stuart Lee Fischman |
First Address | Buffalo, NY 14214-8006 |
Second Address | Buffalo, NY 14214-8006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 08/07/2007 |