Provider Demographics
NPI:1710967716
Name:FISHMAN, ALLA (DO)
Entity Type:Individual
Prefix:MS
First Name:ALLA
Middle Name:
Last Name:FISHMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 COUNTY LINE ROAD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1738
Mailing Address - Country:US
Mailing Address - Phone:215-322-3022
Mailing Address - Fax:215-355-9155
Practice Address - Street 1:1904 COUNTY LINE ROAD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1738
Practice Address - Country:US
Practice Address - Phone:215-322-3022
Practice Address - Fax:215-355-9155
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012044174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist