Individual
MRS. DEBRA SUE FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPAC, MSPA
Contact information
Practice address
540 UNION BLVD, WEST ISLIP, NY 11795-3105
(631) 669-2555
Mailing address
540 UNION BLVD, WEST ISLIP, NY 11795-3105
(631) 669-2555
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000915
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000915
LICENSE
NY
Enumeration date
12/02/2009
Last updated
07/12/2012
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