| Dr. Clifford B. Fisch, Psyd Pc | |
|
702 Bloomingdale Rd Staten Island NY 10309 | |
| (718) 356-8629 | |
| (718) 761-3162 |
| Full Name | Dr. Clifford B. Fisch, Psyd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 702 Bloomingdale Rd, Staten Island, New York |
| Authorized Official Name and Position | Clifford B Fisch (OWNER) |
| Authorized Official Contact | 7183568629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Clifford B. Fisch, Psyd Pc 702 Bloomingdale Rd Staten Island NY 10309-1606 Ph: (718) 356-8629 | Dr. Clifford B. Fisch, Psyd Pc 702 Bloomingdale Rd Staten Island NY 10309 Ph: (718) 356-8629 |
| NPI Number | 1639375819 |
|---|---|
| Provider Enumeration Date | 06/25/2007 |
| Last Update Date | 06/08/2018 |
| Medicare PECOS PAC ID | 3678674892 |
|---|---|
| Medicare Enrollment ID | O20070718000428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639375819 | NPI | - | NPPES |
| 02574874 | Medicaid | NY | |
| 167144P | Other | NY | HIP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 015562 (New York) | Primary |
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