Individual
IOSIF FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
965 NOSTRAND AVE, BROOKLYN, NY 11225-2906
(718) 778-5222
Mailing address
2161 E 72ND ST, BROOKLYN, NY 11234-6228
(718) 778-5222
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045058
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01580107
—
NY
01
—
045058
LICENSE
NY
Enumeration date
04/17/2007
Last updated
03/07/2023
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