Provider Demographics
NPI:1295390037
Name:FISHZON, ANNA (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:FISHZON
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MORNINGSIDE DR APT 4J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7118
Mailing Address - Country:US
Mailing Address - Phone:914-320-6899
Mailing Address - Fax:
Practice Address - Street 1:19 HUDSON ST RM 404
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3822
Practice Address - Country:US
Practice Address - Phone:914-320-6899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001045102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst