Individual
DR. PETER E. FISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6 WELLNESS WAY STE G03, LATHAM, NY 12110-2156
(518) 785-5884
(518) 783-6890
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036118047
IL
208600000X
Surgery Physician
Primary
249922
NY
390200000X
Student in an Organized Health Care Education/Training Program
060-0003317
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03028439
—
NY
01
—
P00857183
RR MEDICARE
NY
Enumeration date
03/15/2007
Last updated
04/03/2024
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