Individual
MR. VITALY FISHBEIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
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
174400000X
Specialist
Primary
25MA05902900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000908
—
NJ
Enumeration date
05/02/2006
Last updated
07/08/2007
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