Healthcare Provider Details

I. General information

NPI: 1215957634
Provider Name (Legal Business Name): JOANNE REIFFE FISHBANE D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 CLARKSVILLE RD SUITE 4D
WEST WINDSOR NJ
08550-5300
US

IV. Provider business mailing address

231 CLARKSVILLE RD SUITE 4D
WEST WINDSOR NJ
08550-5300
US

V. Phone/Fax

Practice location:
  • Phone: 609-275-5400
  • Fax: 609-275-2839
Mailing address:
  • Phone: 609-275-5400
  • Fax: 609-275-2839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDI12436
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: