Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 25MA08290600 | NJ |
Y | 208000000X | Pediatrician | 25MAO8290600 | NJ |
N | 2086S0120X | Pediatric Surgery | 25MA08290600 | NJ |
NPI | 1558536920 |
---|---|
Provider Name | Elisabeth Fishbein |
First Address | Englewood, NJ 07631-1808 |
Second Address | Englewood, NJ 07631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 28/04/2008 |