Provider Demographics
NPI:1033181748
Name:FISHMAN, CYBELE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYBELE
Middle Name:
Last Name:FISHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 FIDDLERS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-3278
Mailing Address - Country:US
Mailing Address - Phone:917-679-9480
Mailing Address - Fax:
Practice Address - Street 1:240 W 37TH ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5787
Practice Address - Country:US
Practice Address - Phone:917-634-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226205207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3K0171Medicare PIN
NYH90817Medicare UPIN
H90817Medicare UPIN