Healthcare Provider Details

I. General information

NPI: 1609983139
Provider Name (Legal Business Name): FISZBEIN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 11/15/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 E LOHMAN AVE STE B
LAS CRUCES NM
88011-8255
US

IV. Provider business mailing address

5746 TROWBRIDGE DR
EL PASO TX
79925-3341
US

V. Phone/Fax

Practice location:
  • Phone: 915-219-4300
  • Fax: 915-519-4300
Mailing address:
  • Phone: 915-219-4300
  • Fax: 915-519-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM FISZBEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 915-219-4300