# HEIDI FYRBERG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699895672
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA100180 | MA | — |
| 363AS0400X | Surgical Physician Assistant | 005916 | NY | Yes |

## Other

- **Enumeration date:** 03/31/2007
- **Last updated:** 12/30/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | A400118590 | PTAN QSNY1 | NY |
| 01 | — | A400123912 | MCARE PTAN QSNY2 | NY |