Individual
MR. ALBERT S FISKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
90 E MAIN ST STE H, PATCHOGUE, NY 11772-3176
(888) 722-2072
Mailing address
14 LOCUST AVE N, MEDFORD, NY 11763-1604
(631) 310-7285
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F406359-01
NY
Other
Enumeration date
11/06/2023
Last updated
09/29/2024
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