Organization
VITALY FISHBEIN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITALY FISHBEIN M.D. (PRESIDENT)
(973) 736-1112
Entity
Organization
Contact information
Practice address
401 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-2935
(973) 736-1112
(973) 736-5590
Mailing address
401 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-2935
(973) 736-1112
(973) 736-5590
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MA05902900
NJ
207ZP0101X
Anatomic Pathology Physician
MA07148100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000908
—
NJ
Enumeration date
01/15/2008
Last updated
01/15/2008
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