Individual
GIDEON FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 S BOULEVARD, NYACK, NY 10960-3604
(845) 675-4780
Mailing address
1 S BOULEVARD, NYACK, NY 10960-3604
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
67 002990
NY
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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