MEDICARE: MRS. PAULA G. FISHBEIN M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	006882-1	NY

General Provider Information

NPI Number	:	1992008635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA G. FISHBEIN M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	35 FAIRWAY AVE
Second Line	:
City	:	DELMAR
State	:	NY
Zip	:	12054-3332
Country	:	US
Telephone Number	:	518-439-1198
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 VERDA LANE
Second Line	:
City	:	CLARKSVILLE
State	:	NY
Zip	:	12041
Country	:	US
Telephone Number	:	518-768-2318
Fax Number	:	518-768-8081

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

Provider Enumeration Date	:	12/20/2010
Last Update Date	:	12/20/2010

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Directions to “ MRS. PAULA G. FISHBEIN M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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