Provider Demographics
NPI:1740262187
Name:FISHMAN, ROBIN C (PA)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:C
Last Name:FISHMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:2001 CENTRO FAMILIAR BLVD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105
Mailing Address - Country:US
Mailing Address - Phone:505-873-7400
Mailing Address - Fax:505-873-7473
Practice Address - Street 1:1401 WILLIAM ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-4661
Practice Address - Country:US
Practice Address - Phone:505-768-5450
Practice Address - Fax:505-873-7473
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2011-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM83PA004363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant