Individual
SHANE AMIR FISCHBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
124 HARVARD ST, BROOKLINE, MA 02446-6478
(617) 898-0723
Mailing address
124 HARVARD ST, BROOKLINE, MA 02446-6478
(617) 898-0723
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
295162
MA
Other
Enumeration date
03/22/2019
Last updated
07/05/2023
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