Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 006554 | NY |
NPI | 1083933618 |
---|---|
Provider Name | Timothy Fishman |
First Address | New Windsor, NY 12553-7846 |
Second Address | New Windsor, NY 12553-7846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2010 |
Last Update Date | 25/04/2013 |