Provider Demographics
NPI:1043290521
Name:FISCHBACH, MARNIN ELI (MD)
Entity Type:Individual
Prefix:
First Name:MARNIN
Middle Name:ELI
Last Name:FISCHBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 SUMMERSET DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2537
Mailing Address - Country:US
Mailing Address - Phone:412-521-6888
Mailing Address - Fax:
Practice Address - Street 1:100 NORTHPOINTE CIR
Practice Address - Street 2:SUITE 306
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7851
Practice Address - Country:US
Practice Address - Phone:724-772-4848
Practice Address - Fax:724-772-4888
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072287L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA055118Medicare ID - Type Unspecified