Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 013619 | NY |
Y | 103G00000X | Clinical Psychologist | 013619 | NY |
Y | 103TC0700X | Clinical Psychologist | 013619 | NY |
N | 103TP2701X | Group Psychotherapist | 013619 | NY |
NPI | 1588741730 |
---|---|
Provider Name | Michael Steven Fisher |
First Address | New York, NY 10001-4512 |
Second Address | New York, NY 10025-3533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 18/02/2011 |