Healthcare Provider Details

I. General information

NPI: 1063657005
Provider Name (Legal Business Name): BARBARA G. FISHKIN RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

1365 YORK AVE
NEW YORK NY
10021-4035
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-5483
  • Fax: 646-962-0363
Mailing address:
  • Phone: 646-962-5483
  • Fax: 646-962-0363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number013022
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number013022
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number013022
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: