Provider Demographics
NPI:1003179391
Name:FISHMAN, DAWN VICTORIA
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:VICTORIA
Last Name:FISHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2991 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4830
Mailing Address - Country:US
Mailing Address - Phone:516-781-6857
Mailing Address - Fax:
Practice Address - Street 1:2991 SHORE RD
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-4830
Practice Address - Country:US
Practice Address - Phone:516-781-6857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist