Organization Active NPI

Vitaly Fishbein MD LLC

  • Gastroenterology Physician
  • West Orange, NJ
National Provider Identifier
1174709653
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MA05902900 Issued in NJ
Legal business name
VITALY FISHBEIN MD LLC
Practice address
401 Pleasant Valley Way
West Orange, NJ 07052-2935
Phone
(973) 736-1112
Fax
(973) 736-5590
NPI assigned
Jan 15, 2008
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vitaly Fishbein, M.D.NPI 1467410381
Title
President
Phone
(973) 736-1112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X MA05902900 NJ Primary
Anatomic Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0101X MA07148100 NJ

Addresses

Primary practice location

401 Pleasant Valley Way
West Orange, NJ 07052-2935

Mailing address

401 Pleasant Valley Way
West Orange, NJ 07052-2935
Phone (973) 736-1112

National Provider Directory

National Provider Directory

Locations

401 Pleasant Valley Way
Ste 1
West Orange, NJ 07052
Phone (973) 736-1112

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1174709653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522935",
            "telephone_number": "973-736-1112",
            "fax_number": "973-736-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522935",
            "telephone_number": "973-736-1112",
            "fax_number": "973-736-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALY FISHBEIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "FISHBEIN",
        "authorized_official_first_name": "VITALY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-736-1112",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA05902900",
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NJ",
            "license": "MA07148100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.