Provider Demographics
NPI:1790807394
Name:FLEISHMAN, HERBERT (RPH)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:FLEISHMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 BEECH DR S
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1130
Mailing Address - Country:US
Mailing Address - Phone:201-265-8982
Mailing Address - Fax:201-265-8131
Practice Address - Street 1:189 BEECH DR S
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1130
Practice Address - Country:US
Practice Address - Phone:201-265-8982
Practice Address - Fax:201-265-8131
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01338000183500000X
NY027010-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist