CLIFFORD FISCH (NPI# 1104911643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104911643 |
| Entity Type | Individual |
| Full Name | DR. CLIFFORD FISCH |
| Gender | Male |
| Credential | PSY.D |
| Practice Address | 702 Bloomingdale Road Staten Island NY 10309 |
| Practice Telephone | 7183568629 |
| Practice Fax Number | 7189830348 |
| Mailing Address | 6475 Amboy Road Staten Island NY 10309 |
| Mailing Telephone | 7183568629 |
| Mailing Fax Number | 7189830348 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-09 |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 103TC0700X | Psychologist Specialization: Clinical | 015562 | NY | Behavioral Health & Social Service Providers |
| Identifier | State | Issuer | Type Code |
|---|---|---|---|
| 02574874 | NY | MEDICAID |
| PECOS Associate Control (PAC) ID | 3678564440 by Medicare Provider Enrollment and Chain/Ownership System (PECOS) |
| Professional Enrollment ID | I20040520000635 |
| Last Name | FISCH |
| First Name | CLIFFORD |
| Middle Name | B |
| Credential | CP |
| Location | 702 Bloomingdale Rd, Staten Island, NY 10309-1606 |
| Graduation Year | 2001 |
| Primary Specialty | PSYCHOLOGIST, CLINICAL |
| Street Address | 702 BLOOMINGDALE ROAD |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154816650 | Nikki Schechter | Occupational Therapist | 3495 Richmond Road, Staten Island, NY 10309 | 2018-06-27 |
| 1659878213 | Pauline Izzo | Nurse Practitioner · Family | 544 Darlington Ave, Staten Island, NY 10309 | 2018-04-10 |
| 1053822544 | Dufort Psychological Services Pllc | Psychologist · Cognitive & Behavioral | 401 Bloomingdale Rd Suite 6, Staten Island, NY 10309 | 2017-10-24 |
| 1902324361 | Anthony Orefice | Home Health | 55 Robin Ct, 1 St Floor, Staten Island, NY 10309 | 2017-09-06 |
| 1770007767 | Graceann Cotroneo | Specialist | 61 Plumtree Lane, 1st Fl, Staten Island, NY 10309 | 2017-08-01 |
| 1477075836 | Matthew Jordan Levine | Specialist | 15 Redwood Loop, Staten Island, NY 10309 | 2017-07-07 |
| 1619339256 | Empire Vision Center, Inc. · Davis Visionworks | Eyewear Supplier (Equipment, not the service) | 205 Bricktown Way, Ste A, Staten Island, NY 10309 | 2016-03-23 |
| 1295109692 | Danielle Kinsman | Early Intervention Provider Agency | 1007 Edgegrove Avenue, Staten Island, NY 10309 | 2015-11-23 |
| 1811363591 | Daniella Aryeh | Speech-Language Pathologist | 997 Stafford Avenye, Staten Island, NY 10309 | 2015-08-17 |
| 1649652058 | Visions By Victoria Rose Ltd. | Technician/Technologist · Optician | 639 Veterans Road West, Suite 5(e), Staten Island, NY 10309 | 2015-06-22 |
| Find all providers in zip 10309 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003311218 | Valentina Teresa Diglio | 1110 South Ave Ste 5, Staten Island, NY 10314-3403 | 2018-03-28 | |
| 1407205842 | Neil B Madero | 67 Jackson St, Staten Island, NY 10304-2229 | 2016-06-07 | |
| 1306210125 | Ife Landsmark | New Broadview Manor - 70 Father Capodanno Blvd, Staten Island, NY 10305 | 2015-11-17 | |
| 1639578206 | Pakier Psychological Services P.C. | 1550 Richmond Ave Ste 203, Staten Island, NY 10314-1578 | 2014-08-19 | |
| 1316286800 | Dawson D Dufort | 256 Woodward Ave, Staten Island, NY 10314-4237 | 2013-02-04 | |
| 1053695072 | Shveta Mittal | 180 Four Corners Rd, Staten Island, NY 10304-1222 | 2011-10-10 | |
| 1841571312 | Susan Merle Tyburczy | 152 Ross Ave, Staten Island, NY 10306-2952 | 2011-08-29 | |
| 1194022004 | Lauriann Mancini · Lauriann Castrogiovanni | 28 Brookside Loop, Staten Island, NY 10309-4501 | 2011-02-12 | |
| 1780842922 | Linda Marconi-Manda · Linda Marconi Manda | 78 Cedarcliff Road, Staten Island, NY 10301-4402 | 2008-05-23 | |
| 1962669374 | Lucia Anna Bove | 74 Nesmythe Terrace, Staten Island, NY 10301 | 2008-05-22 | |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639375819 | Dr. Clifford B. Fisch, Psyd PC | Psychologist · Clinical | 702 Bloomingdale Rd, Staten Island, NY 10309 | 2007-06-25 |
| 1487852521 | Charles Fisch · Charles Fisch | Social Worker · Clinical | 425 Kings Hwy, Brooklyn, NY 11223-1629 | 2007-07-10 |
| 1275731457 | Ronald David Fisch · Ronald David Fisch | Counselor · Mental Health | 2685 Lake Way, Cooper City, FL 33026-3671 | 2007-07-10 |
| 1366717902 | Clifford LLC · Clifford Adult Foster Care | Foster Care Agency | 2039 Clifford St, Flint, MI 48503-4005 | 2012-03-15 |
| 1467478081 | Clifford, LLC · Clifford Prime Care Afc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2039 Clifford St, Flint, MI 48503-4005 | 2006-07-15 |
| 1316299431 | Celestine Clifford · Celeste Clifford | Case Manager/Care Coordinator | 1153 10th St, Suite A, Clermont, FL 34711-2872 | 2012-10-12 |
| 1235183518 | Clifford Family Chiropractic | Chiropractor | Mt View Plaza, Suite 3, Clifford, PA 18413-0009 | 2006-05-20 |
| 1215038344 | K. S. Clifford Clifford Chao | Radiology · Radiation Oncology | 622 West 168th Street, New York, NY 10032-3720 | 2006-09-25 |
| 1518145879 | Clifford Township Volunteer Fire Company | Ambulance · Land Transport | 84 Main St, Clifford, PA 18413-9800 | 2008-02-08 |
| 1275874513 | Elizabeth Ann Clifford · Betsy Ann Clifford | Speech-Language Pathologist | 351 Northwest Gregory, Lee's Summit, MO 64064 | 2013-03-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.