Active NPI
Mark B. Fishtein, D.O.
- Psychiatry Physician
- Malvern, PA
National Provider Identifier
1487924742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OS002884-L
- Practice address
- 18 Dobs LN
Malvern, PA 19355-9633 - Phone
- (610) 647-3352
- NPI assigned
- Jan 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OS002884-L | PA | Primary |
Addresses
Primary practice location
18 Dobs LN
Malvern, PA 19355-9633
Mailing address
18 Dobs LN
Malvern, PA 19355-9633
Phone (610) 647-3352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS002884-L | PA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware Valley Behavioral Health, P.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Geriatric Psychiatry Physician
- Wynnewood, PA
- NPI 1700895240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1487924742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 DOBS LN",
"city": "MALVERN",
"state": "PA",
"postal_code": "193559633",
"telephone_number": "610-647-3352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 DOBS LN",
"city": "MALVERN",
"state": "PA",
"postal_code": "193559633",
"telephone_number": "610-647-3352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHTEIN",
"first_name": "MARK",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-04",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OS002884-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malvern, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.