Vitaly Fishbein MD LLC

Organization Active NPI Gastroenterology Physician · West Orange, NJ

NPI 1174709653 · NPPES record last updated Jan 15, 2008

Key facts

NPI
1174709653
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
License
MA05902900 (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
Organization subpart
No

Authorized official

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

National Provider Directory

Locations

401 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 669-5931

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RG0100X MA05902900 NJ Yes
Anatomic Pathology Physician
Group: 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

Other identifiers

IdentifierTypeStateIssuer
6000908MedicaidNJ

Other providers in West Orange, NJ

All providers in West Orange, NJ · Gastroenterology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.