Provider Demographics
NPI:1558536920
Name:FISHBEIN, ELISABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:FISHBEIN
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 1:1275 SUMER STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-324-4109
Mailing Address - Fax:203-969-1271
Practice Address - Street 1:1275 SUMER STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905
Practice Address - Country:US
Practice Address - Phone:203-324-4109
Practice Address - Fax:203-969-1271
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08290600207PP0204X, 2086S0120X
NJ25MAO8290600208000000X
CT054191208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery