Provider Demographics
NPI:1447472337
Name:FISCHBACHER, ELISE
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:
Last Name:FISCHBACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ELISE
Other - Middle Name:MCCREA
Other - Last Name:FISCHBACHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:175 EAST 74 STREET 20B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-879-6214
Mailing Address - Fax:212-988-8001
Practice Address - Street 1:175 EAST 74 STREET 20B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-879-6214
Practice Address - Fax:212-988-8001
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000674-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst