Provider Demographics
NPI:1487795969
Name:FLEISCHER, NOEL RONNIE (M D)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:RONNIE
Last Name:FLEISCHER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E 86TH ST
Mailing Address - Street 2:25B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6458
Mailing Address - Country:US
Mailing Address - Phone:212-517-9337
Mailing Address - Fax:
Practice Address - Street 1:2 W 86TH ST
Practice Address - Street 2:4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3666
Practice Address - Country:US
Practice Address - Phone:212-769-1700
Practice Address - Fax:212-875-8261
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1457202084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB20302Medicare UPIN
NY95D041Medicare ID - Type UnspecifiedMEDICARE PROVIDER #