Individual
DR. KEITH S. FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
30 CENTRAL PARK S, SUITE 5C, NEW YORK, NY 10019-1628
(212) 813-1780
(212) 644-8266
Mailing address
30 CENTRAL PARK S, SUITE 5C, NEW YORK, NY 10019-1628
(212) 813-1780
(212) 644-8266
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
044131
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01690495
—
NY
01
—
245824
CIGNA
—
01
—
3032829
AETNA
—
01
—
42531
DHA
—
01
—
5832282
DMO
—
Enumeration date
11/01/2006
Last updated
07/08/2007
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