Provider Demographics
NPI:1487431953
Name:FISCHER, STEVEN THOMAS (PA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:THOMAS
Last Name:FISCHER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6444
Mailing Address - Country:US
Mailing Address - Phone:631-235-4931
Mailing Address - Fax:
Practice Address - Street 1:32 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6444
Practice Address - Country:US
Practice Address - Phone:631-235-4931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030416363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant