Healthcare Provider Details

I. General information

NPI: 1700859956
Provider Name (Legal Business Name): ABRAHAM FISZBEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 11/15/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 E LOHMAN AVE
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: 575-556-7600
  • Fax:
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 Number94-43
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: