Provider Demographics
NPI:1174790737
Name:HOWARD FISHMAN
Entity type:Organization
Organization Name:HOWARD FISHMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPLIER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-488-0383
Mailing Address - Street 1:3003 NEW HYDE PARK RD
Mailing Address - Street 2:311
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1214
Mailing Address - Country:US
Mailing Address - Phone:516-488-0383
Mailing Address - Fax:516-327-0506
Practice Address - Street 1:3003 NEW HYDE PARK RD
Practice Address - Street 2:311
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1214
Practice Address - Country:US
Practice Address - Phone:516-488-0383
Practice Address - Fax:516-327-0506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT004641-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0957420002Medicare NSC
NYC42162Medicare PIN