MEDICARE: MS. BONNIE ELIZABETH FISHMAN MSW

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	1041C0700X	Clinical Social Worker	1019473	MA

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	:	1568455285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BONNIE ELIZABETH FISHMAN MSW

Provider Business Mailing Address
First Line	:	55 FRUIT ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-2621
Country	:	US
Telephone Number	:	617-889-8515
Fax Number	:	617-889-8509

Provider Business Practice Location Address
First Line	:	151 EVERETT AVE
Second Line	:	MGH CHELSEA HEALTH CENTER
City	:	CHELSEA
State	:	MA
Zip	:	02150
Country	:	US
Telephone Number	:	617-889-8515
Fax Number	:	617-889-8509

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

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	07/08/2007

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