Provider Demographics
NPI:1174874879
Name:FISCHMAN, DEBORAH A (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:FISCHMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 COLGATE RD
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1919
Mailing Address - Country:US
Mailing Address - Phone:631-427-9708
Mailing Address - Fax:
Practice Address - Street 1:210 E MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2979
Practice Address - Country:US
Practice Address - Phone:631-683-5108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019372103TC0700X
NY019372-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist