1437224722 NPI number — MS. HELENE FISHMAN LCSW

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437224722 NPI number — MS. HELENE FISHMAN LCSW

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

FISHMAN

Provider First Name:

HELENE

Provider Middle Name:

Provider Name Prefix Text:

MS.

Provider Name Suffix Text:

Provider Credential Text:

LCSW

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1437224722

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/07/2012

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

6 SMITH ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

NANUET

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

10954-2913

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

845-623-7782

Provider Business Mailing Address Fax Number:

845-623-0648

Provider First Line Business Practice Location Address:

6 SMITH ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NANUET

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

10954-2913

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

845-623-7782

Provider Business Practice Location Address Fax Number:

845-623-0648

Provider Enumeration Date:

11/21/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 104100000X , with the licence number:  R0261771 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 5368722 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 242674 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
• Identifier: 11157362 . This is a "MULTI PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 6010304 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
• Identifier: 01549224 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 143252000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 244189 . This is a "VALUE OPTION" identifier . This identifiers is of the category "OTHER".
• Identifier: 294335 . This is a "IP" identifier . This identifiers is of the category "OTHER".
• Identifier: HMO . This is a "2612288" identifier . This identifiers is of the category "OTHER".
• Identifier: RK0000304 . This is a "SELECT PRO" identifier . This identifiers is of the category "OTHER".
• Identifier: 040426032641 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
• Identifier: 6274283 . This is a "UBH" identifier . This identifiers is of the category "OTHER".
• Identifier: 9280542 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 1018720 . This is a "BEACON HILL" identifier . This identifiers is of the category "OTHER".
• Identifier: PUPB82344 . This is a "AM PSY SYS" identifier . This identifiers is of the category "OTHER".
• Identifier: 6280271 . This is a "UNITED HEALTH" identifier . This identifiers is of the category "OTHER".