MEDICARE: JUDITH T. FISHBEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	02924R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174630131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH T. FISHBEIN MD

Provider Business Mailing Address
First Line	:	6432 MILLSTONE AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-5110
Country	:	US
Telephone Number	:	225-766-9515
Fax Number	:

Provider Business Practice Location Address
First Line	:	8490 PICARDY AVE
Second Line	:	RM 711
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3731
Country	:	US
Telephone Number	:	225-767-1437
Fax Number	:	225-767-5641

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/08/2007

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