Provider Demographics
NPI:1942077201
Name:FISHKIN, MARCIA L (RN)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:L
Last Name:FISHKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MARCIA
Other - Middle Name:L
Other - Last Name:FISHKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:400 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-235-8385
Practice Address - Fax:914-235-3517
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY49468601207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine