Basic Information
| Provider Information | |||||||||
| NPI: | 1487640157 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISCHER | ||||||||
| FirstName: | MITCHELL | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 EAST MAIN STREET | ||||||||
| Address2: | EMERGENCY DEPARTMENT NORTHERN WESTCHESTER HOSPITAL | ||||||||
| City: | MT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146661200 | ||||||||
| FaxNumber: | 9146661965 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 EAST MAIN STREET | ||||||||
| Address2: | EMERGENCY DEPARTMENT NORTHERN WESTCHESTER HOSPITAL | ||||||||
| City: | MT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146661244 | ||||||||
| FaxNumber: | 9146661931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2005 | ||||||||
| LastUpdateDate: | 10/06/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 183313 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1534785 | 01 | UNITED HEALTHCARE | OTHER | 5C6149 | 01 | HEALTHNET | OTHER | 7895711 | 01 | AETNA PPO | OTHER | 06023000074 | 01 | FIDELIS | OTHER | 0173011 | 05 | NJ | MEDICAID | 0495Q1 | 01 | BCBS | OTHER | P2806750 | 01 | OXFORD | OTHER | 10015062 | 01 | CAPITAL DISTR | OTHER | 1092584 | 01 | AETNA HMO | OTHER | 2139650 | 01 | COVENTRY | OTHER | 4147730 | 01 | MVP | OTHER |